Provider Demographics
NPI:1356069629
Name:TEPP, MICHAEL J (MA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:TEPP
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-3149
Mailing Address - Country:US
Mailing Address - Phone:719-439-9869
Mailing Address - Fax:
Practice Address - Street 1:343 W DRAKE RD STE 240
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2880
Practice Address - Country:US
Practice Address - Phone:970-829-0478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0108829101Y00000X
CO0021079101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor