Provider Demographics
NPI:1881613651
Name:JUST, MICHAEL CARL (LPC, LAC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CARL
Last Name:JUST
Suffix:
Gender:M
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:MANCOS
Mailing Address - State:CO
Mailing Address - Zip Code:81328-0726
Mailing Address - Country:US
Mailing Address - Phone:970-799-2303
Mailing Address - Fax:970-882-3626
Practice Address - Street 1:28000 ROAD T
Practice Address - Street 2:
Practice Address - City:DOLORES
Practice Address - State:CO
Practice Address - Zip Code:81323-9203
Practice Address - Country:US
Practice Address - Phone:970-882-1253
Practice Address - Fax:970-882-1500
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO423101YA0400X
CO4279101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4279OtherLPC
CO423OtherLAC