Provider Demographics
NPI:1588389209
Name:SEVERUD, MARIAH NICOLE (BA)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:NICOLE
Last Name:SEVERUD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2921 W 120TH AVE UNIT 100
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2944
Mailing Address - Country:US
Mailing Address - Phone:720-780-2666
Mailing Address - Fax:720-734-3078
Practice Address - Street 1:1650 MADISON AVE STE 102
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5471
Practice Address - Country:US
Practice Address - Phone:612-223-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor