Individual ProviderMimzy Tackney-MoenSocial WorkerBehavioral Health & Social Service ProvidersPractice Address8000 E Prentice Ave Ste D12, Greenwood Village, CO 80111-2759(303) 637-2526PECOS EnrollmentBased on the most recent information from CMS, provider Mimzy Tackney-Moen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1275690612Provider TypeIndividualFull NameTackney-Moen, MimzyTitleMs.CredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date1/3/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address8000 E Prentice Ave Ste D12, Greenwood Village, CO 80111-2759Phone(303) 637-2526Fax(303) 779-7982Mailing LocationMailing Address8000 E Prentice Ave Ste D12, Greenwood Village, CO 80111-2759Phone(303) 637-2526Fax(303) 779-7982Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense985042Colorado