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4440 Barnes Rd Ste 245 Colorado Springs CO 80917-1564 | |
| (719) 600-9455 | |
| (719) 466-9414 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 4440 Barnes Rd Ste 245, Colorado Springs, Colorado |
| Authorized Official Name and Position | Carlos Urias (CO-FOUNDER / OPERATIONS DIRECTOR) |
| Authorized Official Contact | 7197179705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4440 Barnes Rd Ste 245 Colorado Springs CO 80917-1564 Ph: () - | 4440 Barnes Rd Ste 245 Colorado Springs CO 80917-1564 Ph: (719) 600-9455 |
| NPI Number | 1609576784 |
|---|---|
| Provider Enumeration Date | 03/07/2023 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/13/2024 |
| Medicare PECOS PAC ID | 7719337724 |
|---|---|
| Medicare Enrollment ID | O20240103000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609576784 | NPI | - | NPPES |
| Provider Name | Jose Ramon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346656071 PECOS PAC ID: 0547582462 Enrollment ID: I20141204000748 |
| Provider Name | Douglas Tomasin Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063801579 PECOS PAC ID: 3375899792 Enrollment ID: I20180627001572 |
| Provider Name | Tanya Portee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376273151 PECOS PAC ID: 3173998093 Enrollment ID: I20230407000418 |
| Provider Name | Natalie Warner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336735653 PECOS PAC ID: 8729441282 Enrollment ID: I20230830003740 |
| Provider Name | Shannon Marie Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508554445 PECOS PAC ID: 1759730542 Enrollment ID: I20231205002280 |
| Provider Name | Rebekah Valerie Rogerson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952046583 PECOS PAC ID: 2466804604 Enrollment ID: I20240123003829 |
| Provider Name | Christina Ann Starkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154066397 PECOS PAC ID: 6305283532 Enrollment ID: I20240325000883 |
| Provider Name | Amber Nicole Roper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700552494 PECOS PAC ID: 4587109863 Enrollment ID: I20240710004801 |
| Provider Name | Kathryn Talbott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598520769 PECOS PAC ID: 3779020755 Enrollment ID: I20240808000935 |
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