Provider Demographics
NPI:1134363138
Name:GUY, MICAH MICHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MICAH
Middle Name:MICHELLE
Last Name:GUY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11635 NEWTON PL
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-5129
Mailing Address - Country:US
Mailing Address - Phone:303-887-3192
Mailing Address - Fax:
Practice Address - Street 1:4891 INDEPENDENCE ST
Practice Address - Street 2:STE. 165
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6752
Practice Address - Country:US
Practice Address - Phone:303-456-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3621041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool