Provider Demographics
NPI:1649747304
Name:HECKENDORN, MICHAEL (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HECKENDORN
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5373 YANK WAY
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1341
Mailing Address - Country:US
Mailing Address - Phone:720-675-7139
Mailing Address - Fax:
Practice Address - Street 1:12157 W CEDAR DR STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2105
Practice Address - Country:US
Practice Address - Phone:720-675-7139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014325101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health