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926 Russell Ave Walsenburg CO 81089-2134 | |
| (719) 545-2746 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 926 Russell Ave, Walsenburg, Colorado |
| Authorized Official Name and Position | Jennifer Rudnik (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7194231341 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
41 Montebello Rd Ste 204 Pueblo CO 81001-1379 Ph: (719) 545-2746 | 926 Russell Ave Walsenburg CO 81089-2134 Ph: (719) 545-2746 |
| NPI Number | 1952152902 |
|---|---|
| Provider Enumeration Date | 03/28/2024 |
| Last Update Date | 01/22/2025 |
| Certification Date | 01/22/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952152902 | NPI | - | NPPES |
Cynthia Tanaka Counseling And Consulting Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 Russell Ave, Walsenburg, CO 81089 Phone: 719-588-6578 | |
William T Beverly Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 828 W 7th St, Walsenburg, CO 81089 Phone: 719-671-7793 | |