MARY ANN URSICH (NPI# 1023455268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023455268 |
| Entity Type | Individual |
| Full Name | MARY ANN URSICH |
| Credential | MA, LAC, LMFT |
| Practice Address |
420 21st Ave Ste 113 Longmont CO 80501-1441 |
| Practice Telephone | 3038349369 |
| Practice Fax Number | 3038349396 |
| Mailing Telephone | 3038349369 |
| Mailing Fax Number | 3038349396 |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2019-12-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
ACD.0000339 | CO | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | MFT.0001573 | CO | Behavioral Health & Social Service Providers |
| Street Address |
420 21ST AVE STE 113 |
| City | LONGMONT |
| State | CO |
| Zip Code | 80501-1441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194345702 | Dawn Bondi | Psychologist | 420 21st Ave Ste 113, Longmont, CO 80501-1441 | 2020-04-23 |
| 1790305431 | James Edward Gibson | Counselor | 420 21st Ave Ste 113, Longmont, CO 80501-1441 | 2020-04-22 |
| 1134758238 | Amanda Rayl | Counselor | 420 21st Ave Ste 113, Longmont, CO 80501-1441 | 2020-04-02 |
| 1447704010 | Patricia Dickey | Counselor | 420 21st Ave Ste 113, Longmont, CO 80501-1441 | 2016-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376774 | Boulder County Public Health | Public Health or Welfare | 515 Coffman Street, Suite 200, Longmont, CO 80501 | 2020-08-12 |
| 1164032827 | Kidstuff Child and Family Counseling, P.C. | Marriage & Family Therapist | 360 15th Ave, Ste. 104, Longmont, CO 80501 | 2020-08-06 |
| 1861036501 | Stateserv Medical of Colorado | Durable Medical Equipment & Medical Supplies | 63 South Pratt Pkwy, Landmont, CO 80501 | 2019-11-06 |
| 1558915090 | Array Clinical and Therapeutic Services | Assistant Behavior Analyst | 451 21st Ave. Suite B, Longmont, CO 80501 | 2019-08-01 |
| 1275195042 | Alisa Marie Schwegerl | Speech-Language Pathologist | 1800 Stroh Place, Longmont, CO 80501 | 2019-07-02 |
| 1295298545 | Jovahna Pena | Counselor | Behavioral Health Group, 850 23rd Ave Unit A, Longmont, CO 80501 | 2019-04-12 |
| 1659845568 | University Physicians Incorporated | Advanced Practice Midwife | 2030 Mountain View Ave Ste 400, Longmont, CO 80501 | 2019-01-14 |
| 1013404714 | Crafted Physical Therapy Pllc | Physical Therapist | 701 Delaware Ave Unit E, Longmont, CO 80501 | 2018-04-18 |
| 1588110860 | Randall Bonnom | Counselor | 420 21st Ave #113, Longmont, CO 80501 | 2016-08-28 |
| 1225401771 | Sowash Optometry Group, PC | Eyewear Supplier (Equipment, not the service) | 1242 S. Hover Street, Suite C200, Longmont, CO 80501 | 2015-11-05 |
| Find all providers in zip 80501 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283150 | Passages Therapy | Marriage & Family Therapist | 600 S. Airport Rd. Bldg A Ste G, Longmont, CO 80503-6476 | 2020-10-18 |
| 1164032827 | Kidstuff Child and Family Counseling, P.C. | Marriage & Family Therapist | 360 15th Ave, Ste. 104, Longmont, CO 80501 | 2020-08-06 |
| 1811522311 | Joella Whittaker | Marriage & Family Therapist | 356 1/2 Main St Ste 5, Longmont, CO 80501-5527 | 2020-03-05 |
| 1043844624 | Front Range Transitions Counseling & Consultation | Marriage & Family Therapist | 645 Grandview Mdws Dr, Longmont, CO 80503-9440 | 2020-02-23 |
| 1497386890 | Silas Grant Hendrich | Marriage & Family Therapist | 1611 Geneva Cir, Longmont, CO 80503-1752 | 2020-02-04 |
| 1265979512 | Choice Point, Inc | Marriage & Family Therapist | 7877 Danny Brook Ct, Longmont, CO 80503-8880 | 2017-01-25 |
| 1518412089 | Danielle Barcelo | Marriage & Family Therapist | 630 15th Ave Ste 104, Longmont, CO 80501-2764 | 2016-08-24 |
| 1598145096 | Jennifer Lynne Matheson | Marriage & Family Therapist | 703 3rd Ave Ste 202, Longmont, CO 80501-5996 | 2015-06-01 |
| 1053681874 | Aaron Michael Fullmer | Marriage & Family Therapist | 500 Coffman St Ste 204, Longmont, CO 80501-5445 | 2012-01-10 |
| 1811468580 | Cheryl L King | Marriage & Family Therapist | 2101 Gay St, Longmont, CO 80501-1307 | 2018-12-06 |
| Find all providers in LONGMONT | ||||
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| 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.