Provider Demographics
NPI:1659341931
Name:GIGLIO, MICHAEL P (SAP, LMFT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:P
Last Name:GIGLIO
Suffix:
Gender:M
Credentials:SAP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 W. HARVARD ST.
Mailing Address - Street 2:STE. 102
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5200
Mailing Address - Country:US
Mailing Address - Phone:970-218-0612
Mailing Address - Fax:970-221-9818
Practice Address - Street 1:155 W HARVARD ST
Practice Address - Street 2:SUITE # 201
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5200
Practice Address - Country:US
Practice Address - Phone:970-218-0612
Practice Address - Fax:970-221-9818
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT # 257106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62-86306Medicare UPIN