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NPI Code Detail

MEDICARE: JESSE HAYDEN MICHAUD M.A., LPCC

MEDICARE: JESSE HAYDEN MICHAUD M.A., LPCC
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
1101YM0800XMental Health CounselorLPC.0005792CO
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1790845600
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE HAYDEN MICHAUD M.A., LPCC
Provider Business Mailing Address
First Line : 1455 DIXON AVE
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-8879
Country : US
Telephone Number : 303-443-8500
Fax Number :
Provider Business Practice Location Address
First Line : 1455 DIXON AVE
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-8879
Country : US
Telephone Number : 303-443-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 09/19/2023

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