Provider Demographics
NPI:1700604550
Name:FULFILLED MOTHERHOOD COUNSELING LLC
Entity type:Organization
Organization Name:FULFILLED MOTHERHOOD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KYLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:918-217-8440
Mailing Address - Street 1:4495 HALE PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-6206
Mailing Address - Country:US
Mailing Address - Phone:918-217-8440
Mailing Address - Fax:
Practice Address - Street 1:4495 HALE PKWY STE 204
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-6206
Practice Address - Country:US
Practice Address - Phone:918-217-8440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty