Basic Information
| Provider Information | |||||||||
| NPI: | 1265791339 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBB | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | ALLEN | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1424 NUEVA VISTA DR | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802295595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033883545 | ||||||||
| FaxNumber: | 3033886575 | ||||||||
| Practice Location | |||||||||
| Address1: | 1735 PONTIAC ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802201831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037809191 | ||||||||
| FaxNumber: | 3037809192 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2012 | ||||||||
| LastUpdateDate: | 05/10/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | LPC 6388 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.