MICHAEL MACK (NPI# 1114333796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114333796 |
| Entity Type | Individual |
| Full Name | MICHAEL MACK |
| Practice Address |
3450 Broadway St Boulder CO 80304-1824 |
| Mailing Address |
4347 E 135th Way Thornton CO 80241-1583 |
| Practice Telephone | 3034411100 |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851737589 | Michael George Mack | Chiropractor | 1327 Bay View Dr, Devils Lake, ND 58301-8629 | 2013-05-21 |
| 1710239876 | Michael Wesley Mack Jr. | Social Worker | 6605 Abercorn St Ste 101f, Savannah, GA 31405-5896 | 2012-10-12 |
| 1407138712 | Michael Mack | Registered Nurse | 5416 N Lawrence St, Philadelphia, PA 19120-2804 | 2011-09-13 |
| 1235298555 | Michael Edward Mack | Dentist | 7060 Spring Meadows W Dr, Suite B, Holland, OH 43528-8061 | 2006-12-06 |
| 1508952375 | Michael John Mack | Dentist | 40 E. Putnam Ave., Cos Cob, CT 06807 | 2006-10-05 |
| 1962995357 | Michael Mack | Case Manager/Care Coordinator | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2018-06-11 |
| 1902356710 | Michael Anthony Mack | Counselor | 600 Bernard St, Bakersfield, CA 93305-3020 | 2016-10-05 |
| 1245484948 | Michael Mack | Marriage & Family Therapist | 6041 Cadillac Ave, Los Angeles, CA 90034-1702 | 2008-11-07 |
| 1225216997 | Michael Dean Mack | Emergency Medicine | 4480 Utica Ridge Rd, Bettendorf, IA 52722-1644 | 2008-02-05 |
| 1376531913 | Michael J. Mack | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4708 Alliance Blvd, Suite 700, Pavillion I, Plano, TX 75093-5340 | 2005-10-07 |
| Street Address |
3450 BROADWAY ST |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-1824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346324530 | Samuel Widd Medford Jr. | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2006-10-24 |
| 1881002574 | Catherine Ruth Abel | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-26 |
| 1962819797 | Judith Anne Voorhees Brown | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-14 |
| 1134535420 | Michele Ryan | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-08 |
| 1558777144 | Paul Egan Jr. | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-03 |
| 1124434774 | Natasha Stackhouse | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-03 |
| 1588070361 | James Mcmillan | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-01 |
| 1366857120 | Abby Hulser | Community/Behavioral Health | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-06-30 |
| 1487069357 | Patrick Leonard Jeter | Counselor | 3450 Broadway St, Boulder, CO 80304-1899 | 2014-06-30 |
| 1477968469 | Karen Tracy | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063917862 | Amber Ivanova | Counselor | 2525 13th St Ste 200, Boulder, CO 80304-4104 | 2018-03-26 |
| 1326586116 | Alicia Hagge | Counselor | 3050 Broadway St Unit 3, Boulder, CO 80304-3154 | 2017-02-01 |
| 1811351091 | Ashlee Ackelson | Counselor | 5277 Manhattan Cir Ste 114, Boulder, CO 80303-8200 | 2016-04-13 |
| 1831597244 | Annemarie Curran Prairie | Counselor | 2505 Walnut St., Ste 303, Boulder, CO 80302 | 2014-12-17 |
| 1326453341 | Rhae Birmingham | Counselor | 1634 Walnut St Ste 221, Boulder, CO 80302-5400 | 2014-06-27 |
| 1467867952 | John Mccollum | Counselor | 3450 Broadway, Boulder, CO 80304-1899 | 2014-06-24 |
| 1871908244 | Robert Emmer | Counselor | 3450 Broadway St., Boulder, CO 80304-1899 | 2014-06-24 |
| 1316352958 | Alexis Mitsuko Kamakanoe Ornellas | Counselor | 2635 Mapleton Ave Lot 24, Boulder, CO 80304-3828 | 2014-06-23 |
| 1538580261 | Natsumi Minagawa | Counselor | 1800 30th St Ste 308, Boulder, CO 80301-1026 | 2013-12-24 |
| 1821419904 | Cassandra Field | Counselor | 954 North St Unit 308, Boulder, CO 80304-3420 | 2013-12-17 |
| Find all providers in BOULDER | ||||
Please comment or provide details below to improve the information on MICHAEL MACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.