Provider Demographics
NPI:1700959657
Name:NAGEL, MARK ALLAN (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ALLAN
Last Name:NAGEL
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8670 WOLFF CT STE 130
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3692
Mailing Address - Country:US
Mailing Address - Phone:303-668-1697
Mailing Address - Fax:303-430-5306
Practice Address - Street 1:8670 WOLFF CT STE 130
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3692
Practice Address - Country:US
Practice Address - Phone:303-668-1697
Practice Address - Fax:303-430-5306
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO162106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist