MEDICARE: MICHAEL PRESTON TAPP 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	101YM0800X	Mental Health Counselor	1102	CO

General Provider Information

NPI Number	:	1588748008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PRESTON TAPP LPC

Provider Business Mailing Address
First Line	:	7451 S ODESSA CIR
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80016-1753
Country	:	US
Telephone Number	:	303-617-2417
Fax Number	:	303-617-2452

Provider Business Practice Location Address
First Line	:	11059 E BETHANY DR
Second Line	:	200
City	:	AURORA
State	:	CO
Zip	:	80014-2622
Country	:	US
Telephone Number	:	303-617-2417
Fax Number	:	303-617-2452

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/08/2007

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