MEDICARE: GREGORY MCHUGH CCHT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	UNLICENSED PSYCHOTHE	CO

General Provider Information

NPI Number	:	1023290061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY MCHUGH CCHT

Provider Business Mailing Address
First Line	:	PO BOX 100067
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80250-0067
Country	:	US
Telephone Number	:	303-995-4276
Fax Number	:

Provider Business Practice Location Address
First Line	:	1766 S FRANKLIN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-3340
Country	:	US
Telephone Number	:	303-995-4276
Fax Number	:	303-733-2064

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2007
Last Update Date	:	12/01/2007

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