Mary Katherine Connell

Individual provider Active NPI Mental Health Counselor · Leadville, CO

NPI 1861267775 · NPPES record last updated Nov 20, 2023

Key facts

NPI
1861267775
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
0021453 (CO)
Practice address
1713 Mount Lincoln Dr W
Leadville, CO 80461-3708
Phone
(970) 564-7439
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0021453COMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0021453 CO Yes

Addresses

Primary practice location

1713 Mount Lincoln Dr W
Leadville, CO 80461-3708

Mailing address

1713 Mount Lincoln Dr W
Leadville, CO 80461-3708
Phone (970) 564-7439

Other providers in Leadville, CO

All providers in Leadville, CO · Mental Health Counselor in Colorado

Sources for this page

Verify at the official NPI Registry.