Provider Demographics
NPI:1023186772
Name:KIRBY, MICHAEL C (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:KIRBY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 KIPLING ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-8003
Mailing Address - Country:US
Mailing Address - Phone:303-237-4322
Mailing Address - Fax:
Practice Address - Street 1:720 KIPLING ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-8003
Practice Address - Country:US
Practice Address - Phone:303-237-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1335103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist