| Laissa Prati Psychology Private Practice Llc | |
|
300 Boardwalk Dr Unit 5-a Fort Collins CO 80525-3070 | |
| (970) 223-2256 | |
| (970) 223-2324 |
| Full Name | Laissa Prati Psychology Private Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 Boardwalk Dr, Fort Collins, Colorado |
| Authorized Official Name and Position | Laissa Eschiletti Prati (PSYCHOLOGIST) |
| Authorized Official Contact | 9708894862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laissa Prati Psychology Private Practice Llc 6519 Tombstone Ridge Rd Timnath CO 80547-6501 Ph: (970) 889-4862 | Laissa Prati Psychology Private Practice Llc 300 Boardwalk Dr Unit 5-a Fort Collins CO 80525-3070 Ph: (970) 223-2256 |
| NPI Number | 1689124315 |
|---|---|
| Provider Enumeration Date | 10/05/2016 |
| Last Update Date | 04/20/2017 |
| Medicare PECOS PAC ID | 1557643780 |
|---|---|
| Medicare Enrollment ID | O20170124002383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689124315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | PSY.0004455 (Colorado) | Primary |
| Provider Name | Laissa Eschiletti Prati |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427503481 PECOS PAC ID: 4981983996 Enrollment ID: I20161115002429 |
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