MEDICARE: MR. MICHAEL W. LEIKER LPC

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	101YP2500X	Professional Counselor	3457	CO

General Provider Information

NPI Number	:	1306892153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL W. LEIKER LPC

Provider Business Mailing Address
First Line	:	5290 LIVERPOOL ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-8543
Country	:	US
Telephone Number	:	303-923-8867
Fax Number	:

Provider Business Practice Location Address
First Line	:	5290 LIVERPOOL STREET
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-8543
Country	:	US
Telephone Number	:	303-923-8867
Fax Number	:

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	10/25/2010

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