Provider Demographics
NPI:1104144740
Name:STEVENS, MICHELLE J (MA, LPC, NCC, JD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MA, LPC, NCC, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1522
Mailing Address - Country:US
Mailing Address - Phone:303-916-8770
Mailing Address - Fax:
Practice Address - Street 1:2305 E ARAPAHOE RD
Practice Address - Street 2:SUITE 119
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1522
Practice Address - Country:US
Practice Address - Phone:303-916-8770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC-6241101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional