| Doctor Name: | GEORGE RANKIN MACILWINEN |
| NPI Number: | 1770835910 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., LPC, CAC I |
| License Number: | 13670 |
| Business Practice Address: | 2769 Iris Ave Ste 114 Boulder, CO - 803044405 |
| Business Phone Number: | 7204323147 |
| Business Fax Number: | |
| Mailing Address: | 2769 Iris Ave. Ste 114, BOULDER |
| State: | CO |
| Postal Code: | 803040679 |
| Phone Number: | 7204323147 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2012 |
| NPI Last Update Date: | 03/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 13670 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |