Provider Demographics
NPI:1235389891
Name:HILGERS, MICHAEL JEREMY (MMFT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JEREMY
Last Name:HILGERS
Suffix:
Gender:M
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 WEST AVE STE A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1562
Mailing Address - Country:US
Mailing Address - Phone:512-739-4882
Mailing Address - Fax:512-597-3902
Practice Address - Street 1:1502 WEST AVE STE A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1562
Practice Address - Country:US
Practice Address - Phone:512-739-4882
Practice Address - Fax:512-597-3902
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17131101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional