Provider Demographics
NPI:1699442301
Name:MARCY MULLET LPC LLC
Entity type:Organization
Organization Name:MARCY MULLET LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MBR
Authorized Official - Prefix:
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MULLET
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-330-3589
Mailing Address - Street 1:5000 BUTTE STREET
Mailing Address - Street 2:149
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:303-330-3589
Mailing Address - Fax:866-757-5778
Practice Address - Street 1:5000 BUTTE STREET
Practice Address - Street 2:149
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:303-330-3589
Practice Address - Fax:866-757-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty