| Alpha Neuro Llc | |
|
2918 Beacon St Colorado Springs CO 80907-9208 | |
| (214) 701-0158 | |
| Not Available |
| Full Name | Alpha Neuro Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2918 Beacon St, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jessica K Allen (OWNER) |
| Authorized Official Contact | 2147010158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Neuro Llc 2918 Beacon St Colorado Springs CO 80907-9208 Ph: () - | Alpha Neuro Llc 2918 Beacon St Colorado Springs CO 80907-9208 Ph: (214) 701-0158 |
| NPI Number | 1609646835 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 05/13/2024 |
| Certification Date | 05/13/2024 |
| Medicare PECOS PAC ID | 6608217500 |
|---|---|
| Medicare Enrollment ID | O20240509001512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609646835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica Allen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730710054 PECOS PAC ID: 7416398318 Enrollment ID: I20240509001701 |
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