Provider Demographics
NPI:1831103712
Name:MICHAELS, THOMAS FROST (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FROST
Last Name:MICHAELS
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 1:1777 S HARRISON ST
Mailing Address - Street 2:SUITE 840
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3925
Mailing Address - Country:US
Mailing Address - Phone:303-777-7610
Mailing Address - Fax:303-777-5923
Practice Address - Street 1:1777 S HARRISON ST
Practice Address - Street 2:SUITE 840
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3925
Practice Address - Country:US
Practice Address - Phone:303-777-7610
Practice Address - Fax:303-777-5923
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO915103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND9070-6Medicare ID - Type Unspecified