Provider Demographics
NPI:1780396523
Name:MASLANIK, MIRIAM K (LPC)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:K
Last Name:MASLANIK
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 1:2312 EAGLES NEST DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3429
Mailing Address - Country:US
Mailing Address - Phone:303-807-4063
Mailing Address - Fax:
Practice Address - Street 1:2312 EAGLES NEST DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3429
Practice Address - Country:US
Practice Address - Phone:303-807-4063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2022-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty