Healthcare Provider Details

I. General information

NPI: 1770072811
Provider Name (Legal Business Name): MICHAEL DINNEEN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 09/29/2026
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 S QUEBEC ST STE 126B
GREENWOOD VILLAGE CO
80111-2209
US

IV. Provider business mailing address

5600 S QUEBEC ST STE 126B
GREENWOOD VILLAGE CO
80111-2209
US

V. Phone/Fax

Practice location:
  • Phone: 720-935-5903
  • Fax:
Mailing address:
  • Phone: 720-935-5903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4707
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number992263
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: