MEDICARE: MICHAEL DENNIS MISGEN 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	101YM0800X	Mental Health Counselor	2533	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1417962234	OTHER	CO	GROUP NPI
2	841044412	OTHER	CO	PRACTICE TAX ID

General Provider Information

NPI Number	:	1982712147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DENNIS MISGEN LPC

Provider Business Mailing Address
First Line	:	3955 E EXPOSITION AVE
Second Line	:	SUITE 202
City	:	DENVER
State	:	CO
Zip	:	80209-5000
Country	:	US
Telephone Number	:	303-974-0653
Fax Number	:	303-316-7352

Provider Business Practice Location Address
First Line	:	3955 E EXPOSITION AVE
Second Line	:	SUITE 202
City	:	DENVER
State	:	CO
Zip	:	80209-5000
Country	:	US
Telephone Number	:	303-974-0653
Fax Number	:	303-316-7352

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

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	03/25/2019

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Directions to “ MICHAEL DENNIS MISGEN LPC” Practice Location

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