| Gary W.gossage, Licensed Clinical Social Work, Llc | |
|
1910 Payton Cir Colorado Spgs CO 80915-1327 | |
| (701) 400-2592 | |
| Not Available |
| Full Name | Gary W.gossage, Licensed Clinical Social Work, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1910 Payton Cir, Colorado Spgs, Colorado |
| Authorized Official Name and Position | Darlene G Gossage (OFFICE MANAGER) |
| Authorized Official Contact | 7014002592 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary W.gossage, Licensed Clinical Social Work, Llc 1910 Payton Cir Colorado Spgs CO 80915-1327 Ph: (701) 400-2592 | Gary W.gossage, Licensed Clinical Social Work, Llc 1910 Payton Cir Colorado Spgs CO 80915-1327 Ph: (701) 400-2592 |
| NPI Number | 1780238469 |
|---|---|
| Provider Enumeration Date | 07/30/2019 |
| Last Update Date | 07/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780238469 | NPI | - | NPPES |
| 37220241 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
The Shandy Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 917 E Moreno Ave Ste 100, Colorado Spgs, CO 80903 Phone: 719-597-0822 Fax: 719-599-4606 |