Provider Demographics
NPI:1881043230
Name:BEARD, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BEARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10025 E GIRARD AVE
Mailing Address - Street 2:APT 26E106
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5554
Mailing Address - Country:US
Mailing Address - Phone:303-809-6420
Mailing Address - Fax:
Practice Address - Street 1:6767 S SPRUCE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1283
Practice Address - Country:US
Practice Address - Phone:303-997-7411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst