Individual provider Active NPI

Bonnie Mucklow, LPC, LMFT, CAC III

  • Marriage & Family Therapist
  • Greenwood Village, CO
National Provider Identifier
1528082179
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
149 Issued in CO
Practice address
7000 E Belleview Ave Ste 203
Greenwood Village, CO 80111-1622
Phone
(720) 488-3822
Fax
(303) 798-3883
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 149 CO Primary

Addresses

Primary practice location

7000 E Belleview Ave Ste 203
Greenwood Village, CO 80111-1622

Mailing address

7000 E Belleview Ave Ste 203
Greenwood Village, CO 80111-1622
Phone (720) 488-3822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231229000952 CO Practitioner - Marriage and Family Therapist 9931559168 Practice locations: Greenwood Village, CO

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7000 E Belleview Ave
Suite 203
Greenwood Village, CO 80111-1622
Phone (720) 488-3822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149COMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Bonnie Mucklow Professional Past Accepting new patients
Gloria Knoll, LCSW, Inc PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1528082179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 E BELLEVIEW AVE STE 203",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801111622",
            "telephone_number": "720-488-3822",
            "fax_number": "303-798-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 E BELLEVIEW AVE STE 203",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801111622",
            "telephone_number": "720-488-3822",
            "fax_number": "303-798-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCKLOW",
        "first_name": "BONNIE",
        "credential": "LPC, LMFT, CAC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

Verify at the official NPI Registry.