Mr Brian Davis, | |
12610 W Bayaud Ave Unit 8, Lakewood, CO 80228-2022 | |
(720) 273-0021 | |
Not Available |
Full Name | Mr Brian Davis |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 12610 W Bayaud Ave Unit 8, Lakewood, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245570399 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC.0017226 (Colorado) | Primary |
Entity Name | Sondermind Provider Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210113002826 |
Mailing Address | Practice Location Address |
---|---|
Mr Brian Davis, 12610 W Bayaud Ave Unit 8, Lakewood, CO 80228-2022 Ph: (720) 273-0021 | Mr Brian Davis, 12610 W Bayaud Ave Unit 8, Lakewood, CO 80228-2022 Ph: (720) 273-0021 |
Mrs. Karen Quinlisk, M.A., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1658 Cole Blvd, Building 6, Suite 295, Lakewood, CO 80401 Phone: 303-748-9065 | |
Erica Lynn Johnson, Counselor Medicare: Medicare Enrolled Practice Location: 200 Union Blvd Ste 200, Lakewood, CO 80228 Phone: 720-468-0806 | |
Luis Kashdaro Luna, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1336 S Welch Cir, Lakewood, CO 80228 Phone: 720-295-0507 | |
Melissa Tilleman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8678 W Dartmouth Pl, Lakewood, CO 80227 Phone: 970-235-0913 | |
Darrin Miller, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12567 W Cedar Dr Ste 100, Lakewood, CO 80228 Phone: 888-719-1097 | |
Jessica Tota, MS, LPCC, CRC Counselor Medicare: Not Enrolled in Medicare Practice Location: 274 Union Blvd Ste 430, Lakewood, CO 80228 Phone: 303-250-1327 | |
Timothy Plucinsky, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8244 W Iliff Ln, Lakewood, CO 80227 Phone: 720-284-9625 |