| Child Attachment And Recovery | |
|
2150 Academy Cir Suite C Colorado Springs CO 80909-1693 | |
| (719) 338-3537 | |
| (719) 358-8248 |
| Full Name | Child Attachment And Recovery |
|---|---|
| Speciality | Social Worker |
| Location | 2150 Academy Cir, Colorado Springs, Colorado |
| Authorized Official Name and Position | Mark Chandler Beal (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7193383537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Attachment And Recovery 2150 Academy Cir Suite C Colorado Springs CO 80909-1693 Ph: (719) 338-3537 | Child Attachment And Recovery 2150 Academy Cir Suite C Colorado Springs CO 80909-1693 Ph: (719) 338-3537 |
| NPI Number | 1386843647 |
|---|---|
| Provider Enumeration Date | 07/16/2007 |
| Last Update Date | 07/21/2013 |
| Medicare PECOS PAC ID | 4183865074 |
|---|---|
| Medicare Enrollment ID | O20130718000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386843647 | NPI | - | NPPES |
| 638171 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW (Colorado) | Primary |
| Provider Name | Mark Beal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790985364 PECOS PAC ID: 8820239528 Enrollment ID: I20130723000269 |
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