Provider Demographics
NPI:1427151224
Name:DOW, MICHAEL MACGREGOR (PSYD, LPC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MACGREGOR
Last Name:DOW
Suffix:
Gender:M
Credentials:PSYD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 CARBON PL STE 200
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-6164
Mailing Address - Country:US
Mailing Address - Phone:303-229-5937
Mailing Address - Fax:
Practice Address - Street 1:3020 CARBON PL STE 200
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-6164
Practice Address - Country:US
Practice Address - Phone:303-229-5937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6071101YA0400X
CO3471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)