Provider Demographics
NPI:1750926820
Name:MAYFIELD COUNSELING CENTERS
Entity type:Organization
Organization Name:MAYFIELD COUNSELING CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:MAYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-452-4803
Mailing Address - Street 1:12295 ORACLE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3901
Mailing Address - Country:US
Mailing Address - Phone:719-452-4803
Mailing Address - Fax:
Practice Address - Street 1:12295 ORACLE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3901
Practice Address - Country:US
Practice Address - Phone:719-452-4803
Practice Address - Fax:719-487-3178
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAYFIELD COUNSELING CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty