OrganizationMindful Therapy Group Of Colorado, PcSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3711 Jfk Pkwy Ste 310, Fort Collins, CO 80525-2658(970) 422-7260(425) 678-6463PECOS EnrollmentBased on the most recent information from CMS, provider Mindful Therapy Group Of Colorado, Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1649092990Provider TypeOrganizationFull NameMindful Therapy Group Of Colorado, PcSubpartYesEnumeration Date10/28/2024Last Updated10/28/2024Contact InformationPractice LocationPractice Address3711 Jfk Pkwy Ste 310, Fort Collins, CO 80525-2658Phone(970) 422-7260Fax(425) 678-6455Mailing LocationMailing Address6505 216th St SW Ste 100, Mountlake Terrace, WA 98043-2089Phone(425) 678-6463Fax(425) 678-6455Authorized OfficialNamePauly, Nicole (Provider Enrollment Manager)Phone(425) 640-7009Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode103TC0700XDescriptionPsychologistBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode106H00000XDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode363LP0808XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer