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General NPI Number Information
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NPI Number | 1710123617
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Entity Type | Individual
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Provider Name | MICHELE C WILLINGHAM MA, LPC, LAC
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Gender | Female
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 11285 HIGHLINE DR
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City | NORTHGLENN
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State | CO
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Zip | 80233-3076
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Country | US
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Telephone | 303-853-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 W 122ND AVE STE 100
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City | WESTMINSTER
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State | CO
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Zip | 80234-2075
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Country | US
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Telephone | 303-853-3500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0000574
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0000188
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 574
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License Number State | CO
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