Individual provider Active NPI

Mary Emma Fawcett, MFTC

  • Marriage & Family Therapist
  • Broomfield, CO
National Provider Identifier
1801407382
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFTC.0014311 Issued in CO
Practice address
12303 Airport Way Ste 125
Broomfield, CO 80021-2729
Phone
(970) 310-3406
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPCC.0017575 CO
Marriage & Family Therapist 106H00000X MFTC.0014311 CO Primary

Addresses

Primary practice location

12303 Airport Way Ste 125
Broomfield, CO 80021-2729

Mailing address

2950 Tennyson St
Denver, CO 80212-3029
Phone (303) 433-2541

Other practice location 1

Tennyson Center For Children
2950 Tennyson St
Denver, CO 80212
Phone (303) 433-2541

Other practice location 2

2950 Tennyson St
Denver, CO 80212-3029
Phone (303) 433-2541

Other identifiers 1

IdentifierTypeStateIssuer
LPCC.0017575MedicaidCO

Other names 1

  • Mary Schimke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPCC.0017575COMDCounselor
MFTC.0014311COMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1801407382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 TENNYSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802123029",
            "telephone_number": "303-433-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 AIRPORT WAY STE 125",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212729",
            "telephone_number": "970-310-3406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Tennyson Center For Children",
            "address_2": "2950 Tennyson St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "80212",
            "country_code": "US",
            "telephone_number": "303-433-2541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2950 Tennyson St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802123029",
            "country_code": "US",
            "telephone_number": "303-433-2541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWCETT",
        "first_name": "MARY",
        "middle_name": "EMMA",
        "credential": "MFTC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CO",
            "license": "LPCC.0017575",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "MFTC.0014311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LPCC.0017575",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SCHIMKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.