Mama Bird Wellness, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

CSW.00002154 Issued in CO

Legal business name

MAMA BIRD WELLNESS, LLC

Practice address

424 E Simpson St
Lafayette, CO 80026-2328

Phone

(303) 835-3552

NPI assigned

Apr 28, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jessica Hanlin, LCSWNPI 1962863787

Title

Owner

Phone

(303) 835-3552

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Hanlin, LCSW

  • Clinical Social Worker
  • Lafayette, CO
  • NPI 1962863787
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1154776946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 E 167TH WAY",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "806027650",
            "telephone_number": "303-835-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 E SIMPSON ST",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262328",
            "telephone_number": "303-835-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMA BIRD WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "HANLIN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-835-3552",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CO",
            "license": "CSW.00002154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daus Mahnke, M.D.
• Catherine Major, LPN
• Amy Mak, LMT
• Nicole Makris, MA, ATC, CFO
• Chris Maldonado I
• Tadgh Mander, PA-C
• Emily Maness
• Daniel Manilla
• Elyse Marie Manteris, PH.D., LP
• Bethany Manzanares, M.S., CCC-SLP

• Community/Behavioral Health Agency in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Community/Behavioral Health Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.