| |
2950 Professional Pl Ste 201 Colorado Springs CO 80904-8106 | |
(443) 255-3748 | |
(719) 453-0224 |
Full Name | |
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Speciality | Social Worker |
Location | 2950 Professional Pl Ste 201, Colorado Springs, Colorado |
Authorized Official Name and Position | Jeffrey Donald Plankeel (OWNER / PROVIDER) |
Authorized Official Contact | 4432553748 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2950 Professional Pl Ste 201 Colorado Springs CO 80904-8106 Ph: (443) 255-3748 | 2950 Professional Pl Ste 201 Colorado Springs CO 80904-8106 Ph: (443) 255-3748 |
NPI Number | 1033536149 |
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Provider Enumeration Date | 03/26/2014 |
Last Update Date | 11/26/2018 |
Medicare PECOS PAC ID | 5193942043 |
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Medicare Enrollment ID | O20140816000096 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033536149 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 930 (Colorado) | Primary |
Provider Name | Jeffrey D Plankeel |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1285818971 PECOS PAC ID: 7315028149 Enrollment ID: I20080117000317 |
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