Mr Michael Elden Hillstrom, | |
112 Iowa Ave Ste 4, Colorado Springs, CO 80909-5947 | |
(719) 358-7338 | |
(844) 273-2340 |
Full Name | Mr Michael Elden Hillstrom |
---|---|
Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 112 Iowa Ave Ste 4, Colorado Springs, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962975813 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | ACB.0008413 (Colorado) | Primary |
Entity Name | E Dawn Martin Caciii Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396235511 PECOS PAC ID: 8325458474 Enrollment ID: O20201102000891 |
Mailing Address | Practice Location Address |
---|---|
Mr Michael Elden Hillstrom, 6102 Colony Cir, Colorado Springs, CO 80919-2235 Ph: (719) 209-3959 | Mr Michael Elden Hillstrom, 112 Iowa Ave Ste 4, Colorado Springs, CO 80909-5947 Ph: (719) 358-7338 |
Elizabeth Anne Beck, LPC CAC III Counselor Medicare: Not Enrolled in Medicare Practice Location: 2790 N Academy Blvd, Suite 206, Colorado Springs, CO 80917 Phone: 719-596-1530 Fax: 719-559-1130 | |
Andrea Wood, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 435 Gold Pass Hts, Colorado Springs, CO 80906 Phone: 719-205-2671 Fax: 719-632-2342 | |
Norma Dejesus, Counselor Medicare: Not Enrolled in Medicare Practice Location: 179 Parkside Dr, Colorado Springs, CO 80910 Phone: 719-572-6300 | |
Sheila Kelly, Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 Parkside Dr, Colorado Springs, CO 80910 Phone: 719-572-6340 | |
Robert B. Wenzel, M.A. LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4360 Montebello Dr Ste 400, Colorado Springs, CO 80918 Phone: 719-593-9228 Fax: 719-598-1705 | |
Dawn Zink, MA LPC NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4975 Austin Bluffs Pkwy, Colorado Springs, CO 80918 Phone: 719-301-5488 | |
Melissa Beth Smart, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1330 Inverness Dr Ste 400, Colorado Springs, CO 80910 Phone: 970-310-3406 |