Provider Demographics
NPI:1558694026
Name:ROBLEDO, MICHAEL (MSW CAC III)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:ROBLEDO
Suffix:
Gender:M
Credentials:MSW CAC III
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:ROBLEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2206 VICTOR ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7400
Mailing Address - Country:US
Mailing Address - Phone:303-923-6531
Mailing Address - Fax:
Practice Address - Street 1:10 FARRAGUT AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5626
Practice Address - Country:US
Practice Address - Phone:719-327-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)