Michael Jay Toothaker, CACIII
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Steamboat, CO
NPI 1417593161 · NPPES record last updated Nov 18, 2019
Key facts
- NPI
- 1417593161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 2662 (CO)
- Practice address
- 320 Oak St.
Steamboat, CO 80477 - Phone
- (970) 761-2207
- NPI assigned
- Nov 18, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2662 | CO | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2662 | CO | Yes |
Addresses
Primary practice location
320 Oak St.
Steamboat, CO 80477
Mailing address
PO Box 773705
Steamboat Springs, CO 80477-3705
Phone (970) 761-2207
Other providers in Steamboat, CO
All providers in Steamboat, CO · Addiction (Substance Use Disorder) Counselor in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.