Provider Demographics
NPI:1700676905
Name:MINDFUL THERAPY GROUP OF COLORADO, P.C.
Entity type:Organization
Organization Name:MINDFUL THERAPY GROUP OF COLORADO, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYOR RELATIONSHIP MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULY
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:425-640-7009
Mailing Address - Street 1:6505 216TH ST SW STE 100
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2089
Mailing Address - Country:US
Mailing Address - Phone:425-640-7009
Mailing Address - Fax:
Practice Address - Street 1:8490 E CRESCENT PKWY STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2802
Practice Address - Country:US
Practice Address - Phone:720-316-6434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty