Healthcare Provider Details

I. General information

NPI: 1275454233
Provider Name (Legal Business Name): MICHAEL MILLER THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 55TH ST
BOULDER CO
80303-1256
US

IV. Provider business mailing address

1500 N GRANT ST STE N
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 720-473-4180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MICHA'EL MILLER
Title or Position: OWNER
Credential:
Phone: 720-473-4180