Provider Demographics
NPI:1477130912
Name:MUGGLI, MELISSA EMILY LAWRANCE (LPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:EMILY LAWRANCE
Last Name:MUGGLI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 S GALILEO PL
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-3279
Mailing Address - Country:US
Mailing Address - Phone:719-404-6831
Mailing Address - Fax:
Practice Address - Street 1:8655 KANE RD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-3339
Practice Address - Country:US
Practice Address - Phone:719-582-8482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0016765101YM0800X
COLPC.0018029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health