Provider Demographics
NPI:1164167169
Name:MULLINS, MADISON ROSE (LPC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:ROSE
Last Name:MULLINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6532 EDGE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8947
Mailing Address - Country:US
Mailing Address - Phone:605-525-1203
Mailing Address - Fax:
Practice Address - Street 1:1133 N PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2502
Practice Address - Country:US
Practice Address - Phone:360-552-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021560101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional