| A Safe Haven In The Springs, Pllc | |
|
16441 Clandestine Ct Monument CO 80132-6126 | |
| (719) 337-4294 | |
| (855) 337-9079 |
| Full Name | A Safe Haven In The Springs, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 16441 Clandestine Ct, Monument, Colorado |
| Authorized Official Name and Position | Deborah L Williamson (SOLE MEMBER) |
| Authorized Official Contact | 7193374294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Safe Haven In The Springs, Pllc 16441 Clandestine Ct Monument CO 80132-6126 Ph: (719) 337-4294 | A Safe Haven In The Springs, Pllc 16441 Clandestine Ct Monument CO 80132-6126 Ph: (719) 337-4294 |
| NPI Number | 1245639228 |
|---|---|
| Provider Enumeration Date | 08/15/2014 |
| Last Update Date | 11/01/2021 |
| Certification Date | 11/01/2021 |
| Medicare PECOS PAC ID | 4183948631 |
|---|---|
| Medicare Enrollment ID | O20150112000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245639228 | NPI | - | NPPES |
| 9000180077 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW.09923611 (Colorado) | Primary |
| Provider Name | Deborah L Williamson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588909246 PECOS PAC ID: 5799009247 Enrollment ID: I20150112000625 |
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