Provider Demographics
NPI:1437664604
Name:HAMERLY, MICHAEL (LPC, CAC II)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HAMERLY
Suffix:
Gender:M
Credentials:LPC, CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S HARDING CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9770
Mailing Address - Country:US
Mailing Address - Phone:303-661-9216
Mailing Address - Fax:
Practice Address - Street 1:2687 NORTHPARK DR STE 103
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3176
Practice Address - Country:US
Practice Address - Phone:303-661-9216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB.0008270101YA0400X
COLPC.0014126101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health