| Doctor Name: | MR. JOHN WALTER MIKITSON |
| NPI Number: | 1215086681 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A.,LPC |
| License Number: | 1672 |
| Business Practice Address: | 11310 Huron St Room 40 Northglenn, CO - 802343046 |
| Business Phone Number: | 7202172636 |
| Business Fax Number: | 3032542653 |
| Mailing Address: | 11310 Huron St, Room 40 NORTHGLENN |
| State: | CO |
| Postal Code: | 802343046 |
| Phone Number: | 7202172636 |
| Fax Number: | 3032542653 |
| NPI Enumeration Date: | 01/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1672 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |