Healthcare Provider Details

I. General information

NPI: 1396850467
Provider Name (Legal Business Name): MICHAEL GEORGE PIPICH L.M.F.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7995 E PRENTICE AVE SUITE 207
GREENWOOD VILLAGE CO
80111-2707
US

IV. Provider business mailing address

7995 E PRENTICE AVE SUITE 207
GREENWOOD VILLAGE CO
80111-2707
US

V. Phone/Fax

Practice location:
  • Phone: 720-255-9113
  • Fax: 303-770-0930
Mailing address:
  • Phone: 720-255-9113
  • Fax: 303-770-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number744
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: