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3630 Sinton Rd Ste 100 Colorado Springs CO 80907-5072 | |
| (719) 460-9055 | |
| (719) 387-4645 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 3630 Sinton Rd Ste 100, Colorado Springs, Colorado |
| Authorized Official Name and Position | Joseph C Hammock (PRESIDENT) |
| Authorized Official Contact | 7194609055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3630 Sinton Rd Ste 100 Colorado Springs CO 80907-5072 Ph: (719) 460-9055 | 3630 Sinton Rd Ste 100 Colorado Springs CO 80907-5072 Ph: (719) 460-9055 |
| NPI Number | 1194926006 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 12/04/2024 |
| Certification Date | 12/04/2024 |
| Medicare PECOS PAC ID | 8224186853 |
|---|---|
| Medicare Enrollment ID | O20091116000307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194926006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 891 (Colorado) | Primary |
| Provider Name | Joseph C Hammock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376714584 PECOS PAC ID: 9638227309 Enrollment ID: I20091116000305 |
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