Provider Demographics
NPI:1770072811
Name:DINNEEN, MICHAEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:DINNEEN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 S QUEBEC ST STE 126B
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2209
Mailing Address - Country:US
Mailing Address - Phone:720-935-5903
Mailing Address - Fax:
Practice Address - Street 1:5600 S QUEBEC ST STE 126B
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2209
Practice Address - Country:US
Practice Address - Phone:720-935-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO992263101YP2500X
CO4707101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4707OtherCACIII
CO4707OtherCACIII