Provider Demographics
NPI:1962377085
Name:ELLALASINGHAM, MICAH
Entity type:Individual
Prefix:
First Name:MICAH
Middle Name:
Last Name:ELLALASINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 S CORONA ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-1722
Mailing Address - Country:US
Mailing Address - Phone:231-883-5274
Mailing Address - Fax:
Practice Address - Street 1:750 W HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2165
Practice Address - Country:US
Practice Address - Phone:231-883-5274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist