Healthcare Provider Details

I. General information

NPI: 1184057358
Provider Name (Legal Business Name): MICHELLE K OHDE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE O BAINBRIDGE

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2987 BERGEN PEAK DR
EVERGREEN CO
80439-2205
US

IV. Provider business mailing address

4851 INDEPENDENCE ST
WHEAT RIDGE CO
80033-6715
US

V. Phone/Fax

Practice location:
  • Phone: 740-398-9697
  • Fax: 877-345-3501
Mailing address:
  • Phone: 303-425-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09928451
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0021134
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI1500088
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: