| Lemmon Psychological Services, Llc | |
|
19 E Willamette Ave Ste A Colorado Springs CO 80903-4944 | |
| (719) 510-1844 | |
| (719) 434-9658 |
| Full Name | Lemmon Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 19 E Willamette Ave Ste A, Colorado Springs, Colorado |
| Authorized Official Name and Position | Lydia Carla Lemmon (OWNER) |
| Authorized Official Contact | 7196357638 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lemmon Psychological Services, Llc 19 E Willamette Ave Ste A Colorado Springs CO 80903-4944 Ph: (719) 510-1844 | Lemmon Psychological Services, Llc 19 E Willamette Ave Ste A Colorado Springs CO 80903-4944 Ph: (719) 510-1844 |
| NPI Number | 1881281624 |
|---|---|
| Provider Enumeration Date | 12/28/2020 |
| Last Update Date | 12/28/2020 |
| Certification Date | 12/28/2020 |
| Medicare PECOS PAC ID | 0648683995 |
|---|---|
| Medicare Enrollment ID | O20210520000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881281624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lydia Carla Lemmon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073670964 PECOS PAC ID: 4981826815 Enrollment ID: I20150305000299 |
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