| Antlers Creek Counseling Center, Pllc | |
|
12106 Rio Secco Rd Peyton CO 80831-4032 | |
| (719) 220-8662 | |
| Not Available |
| Full Name | Antlers Creek Counseling Center, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 12106 Rio Secco Rd, Peyton, Colorado |
| Authorized Official Name and Position | Renee M Martinez-epperson (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7193948797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antlers Creek Counseling Center, Pllc 12106 Rio Secco Rd Peyton CO 80831-4032 Ph: (719) 394-8797 | Antlers Creek Counseling Center, Pllc 12106 Rio Secco Rd Peyton CO 80831-4032 Ph: (719) 220-8662 |
| NPI Number | 1851874515 |
|---|---|
| Provider Enumeration Date | 09/10/2018 |
| Last Update Date | 02/18/2019 |
| Medicare PECOS PAC ID | 4486993359 |
|---|---|
| Medicare Enrollment ID | O20190312000798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851874515 | NPI | - | NPPES |
| 1911930832 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW.09923654 (Colorado) | Primary |
| Provider Name | Renee Michelle Martinez-epperson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851872527 PECOS PAC ID: 5395084263 Enrollment ID: I20190312000943 |
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