| Colin Joseph Psychologist Phd Pllc | |
|
1666 W Pine Cone Way Prescott AZ 86303-6123 | |
| (928) 499-8405 | |
| (928) 227-2574 |
| Full Name | Colin Joseph Psychologist Phd Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1666 W Pine Cone Way, Prescott, Arizona |
| Authorized Official Name and Position | Lisa Lou Shannon-joseph (OFFICE MANAGER) |
| Authorized Official Contact | 9284998405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colin Joseph Psychologist Phd Pllc 1666 W Pine Cone Way Prescott AZ 86303-6123 Ph: (928) 499-8405 | Colin Joseph Psychologist Phd Pllc 1666 W Pine Cone Way Prescott AZ 86303-6123 Ph: (928) 499-8405 |
| NPI Number | 1851969117 |
|---|---|
| Provider Enumeration Date | 06/14/2021 |
| Last Update Date | 07/19/2021 |
| Certification Date | 07/15/2021 |
| Medicare PECOS PAC ID | 7214345495 |
|---|---|
| Medicare Enrollment ID | O20210715000015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851969117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Colin R Joseph |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053577999 PECOS PAC ID: 3274584206 Enrollment ID: I20210708003036 |
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