Deer Oaks Illinois Llc | |
5822 S Lowell Way Littleton CO 80123-2849 | |
(210) 615-3483 | |
Not Available |
Full Name | Deer Oaks Illinois Llc |
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Speciality | Psychologist |
Location | 5822 S Lowell Way, Littleton, Colorado |
Authorized Official Name and Position | Paul A Boskind (CEO-OWNER) |
Authorized Official Contact | 8883656271 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Deer Oaks Illinois Llc 7272 Wurzbach Rd Suite 601 San Antonio TX 78240-4801 Ph: (888) 365-6271 | Deer Oaks Illinois Llc 5822 S Lowell Way Littleton CO 80123-2849 Ph: (210) 615-3483 |
NPI Number | 1316345291 |
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Provider Enumeration Date | 12/09/2014 |
Last Update Date | 09/14/2021 |
Certification Date | 09/14/2021 |
Medicare PECOS PAC ID | 8628375730 |
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Medicare Enrollment ID | O20160404001576 |
Identifier | Type | State | Issuer |
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1316345291 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Kevin Patrick Hardin |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1578588521 PECOS PAC ID: 3870588742 Enrollment ID: I20040419001504 |
Provider Name | Nicole R Toy |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1932212818 PECOS PAC ID: 0143273441 Enrollment ID: I20050228000145 |
Provider Name | Jeffrey Fross |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1275579948 PECOS PAC ID: 8022048651 Enrollment ID: I20050815000095 |
Provider Name | Linda G Owen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1336390780 PECOS PAC ID: 3375829344 Enrollment ID: I20170406001900 |
Provider Name | Aaron Starr |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1154814507 PECOS PAC ID: 1951726769 Enrollment ID: I20200810002761 |
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