Provider Demographics
NPI:1740537919
Name:MANCINI, NICHOLAS (MA, LPC, LMFT)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:MANCINI
Suffix:
Gender:M
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S MADISON ST STE C
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3019
Mailing Address - Country:US
Mailing Address - Phone:720-663-1465
Mailing Address - Fax:
Practice Address - Street 1:121 S MADISON ST
Practice Address - Street 2:SUITE D
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209
Practice Address - Country:US
Practice Address - Phone:720-663-1465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012613101YP2500X
COMFT.0001416106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional