MEDICARE: TIMOTHY MICHAEL FLEMMING

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ADDC.0000422	CO
2	101YP2500X	Professional Counselor	LPCC.0020860	CO

General Provider Information

NPI Number	:	1710753462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY MICHAEL FLEMMING

Provider Business Mailing Address
First Line	:	899 N LOGAN ST STE 209
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3154
Country	:	US
Telephone Number	:	303-808-8554
Fax Number	:

Provider Business Practice Location Address
First Line	:	899 N LOGAN ST STE 209
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3154
Country	:	US
Telephone Number	:	303-808-8554
Fax Number	:

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

Provider Enumeration Date	:	12/04/2023
Last Update Date	:	07/21/2025

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Directions to “ TIMOTHY MICHAEL FLEMMING ” Practice Location

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