Marla M Madrid, MSW, LCSW, LAC, LMFT
Individual provider Active NPI Marriage & Family Therapist · Bennett, CO
NPI 1992046908 · NPPES record last updated Jan 22, 2023
Key facts
- NPI
- 1992046908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFT0001999 (CO)
- Practice address
- 190 S 1St St
Bennett, CO 80102-7860 - Phone
- (303) 644-4240
- Fax
- (303) 644-4250
- NPI assigned
- Mar 15, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160208001108 | CO | Practitioner - Clinical Social Worker | 5193034536 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACD0000719 | CO | MD | Addiction (Substance Use Disorder) Counselor |
| CSW00001915 | CO | MD | Clinical Social Worker |
| MFT0001999 | CO | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ACD0000719 | CO | |
| Clinical Social Worker | 1041C0700X | CSW00001915 | CO | |
| Marriage & Family Therapist | 106H00000X | MFT0001999 | CO | Yes |
Addresses
Primary practice location
190 S 1St St
Bennett, CO 80102-7860
Mailing address
190 S 1St St
Bennett, CO 80102-7860
Phone (303) 644-4240
Other practice location 1
56554 Iowa Ave
Strasburg, CO 80136-0843
Phone (720) 937-2332
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51308266 | Medicaid | CO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | marla@atlascounseling.us |
Other providers in Bennett, CO
- Donna Jones
- Pamela Jordan
- Katherine Lynn Larson
- Liberty Rides Inc.
- Life'S Hope Therapeutic Services PLLC
- Mile High Phlebotomy
- Mindroots Counseling PLLC
- Ruhullah Muhtat
- Open and Affordable Dental Bennett PLLC
- Nicole Jean Prochazka
All providers in Bennett, CO · Marriage & Family Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.