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Provider Information for 1982864070


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MARILYN ELISE SANTORO MA, LPC


Sex: Female

NPI: 1982864070
Last Updated: 2023-12-21
Certification Date: 2023-12-21

Details

NameValue
NPI1982864070
Enumeration Date2008-06-11
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 4141 E DICKENSON PL
DENVER, CO 80222-6012
United States

Phone: 303-504-6500 | Fax:
 
Primary Practice Address 4455 E 12TH AVE
DENVER, CO 80220-2415
United States

Phone: 303-504-7975 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)CO3831Licensed Professional Counselor
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalCO3831
No 101YM0800X - Counselor - Mental Health