MEDICARE: MICHAEL J YERGLER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	4868	CO
2	101YM0800X	Mental Health Counselor	4868	CO
3	106H00000X	Marriage & Family Therapist	4868	CO

General Provider Information

NPI Number	:	1326172933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J YERGLER LPC

Provider Business Mailing Address
First Line	:	2345 ACADEMY PL STE 212
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1681
Country	:	US
Telephone Number	:	719-465-9296
Fax Number	:	719-597-6598

Provider Business Practice Location Address
First Line	:	2345 ACADEMY PL STE 212
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1681
Country	:	US
Telephone Number	:	719-465-9296
Fax Number	:	719-597-6598

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	06/24/2015

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