| Gary L. Kaake, Psyd, Pc | |
|
8790 W Colfax Ave Suite 250 Lakewood CO 80215-4092 | |
| (303) 234-0827 | |
| (303) 234-1771 |
| Full Name | Gary L. Kaake, Psyd, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 8790 W Colfax Ave, Lakewood, Colorado |
| Authorized Official Name and Position | Gary Lee Kaake (PRESIDENT) |
| Authorized Official Contact | 3032340827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary L. Kaake, Psyd, Pc 8790 W Colfax Ave Suite 250 Lakewood CO 80215-4092 Ph: (303) 234-0827 | Gary L. Kaake, Psyd, Pc 8790 W Colfax Ave Suite 250 Lakewood CO 80215-4092 Ph: (303) 234-0827 |
| NPI Number | 1629163720 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 10/03/2007 |
| Medicare PECOS PAC ID | 7911896303 |
|---|---|
| Medicare Enrollment ID | O20040312001303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629163720 | NPI | - | NPPES |
| 64951057 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 1212 (Colorado) | Secondary |
| 103TC0700X | Psychologist - Clinical | 1212 (Colorado) | Primary |
| Provider Name | Gary L Kaake |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114011558 PECOS PAC ID: 1557250941 Enrollment ID: I20041112000754 |
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