Provider Demographics
NPI:1306892153
Name:LEIKER, MICHAEL W (LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:W
Last Name:LEIKER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5290 LIVERPOOL ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8543
Mailing Address - Country:US
Mailing Address - Phone:303-923-8867
Mailing Address - Fax:
Practice Address - Street 1:5290 LIVERPOOL STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8543
Practice Address - Country:US
Practice Address - Phone:303-923-8867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01-0742310OtherIRS TIN