Magic Pebble Collaborative Pllc | |
6200 S Syracuse Way Ste 260 Greenwood Village CO 80111-4739 | |
(802) 216-0390 | |
(802) 357-5151 |
Full Name | Magic Pebble Collaborative Pllc |
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Speciality | Social Worker |
Location | 6200 S Syracuse Way Ste 260, Greenwood Village, Colorado |
Authorized Official Name and Position | Allison E Hansen (FOUNDER & THERAPIST) |
Authorized Official Contact | 8022160390 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Magic Pebble Collaborative Pllc 6200 S Syracuse Way Ste 260 Greenwood Village CO 80111-4739 Ph: (802) 216-0390 | Magic Pebble Collaborative Pllc 6200 S Syracuse Way Ste 260 Greenwood Village CO 80111-4739 Ph: (802) 216-0390 |
NPI Number | 1801567797 |
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Provider Enumeration Date | 09/21/2021 |
Last Update Date | 09/06/2023 |
Certification Date | 09/06/2023 |
Medicare PECOS PAC ID | 9739522517 |
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Medicare Enrollment ID | O20240208002175 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801567797 | NPI | - | NPPES |
6704489 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Allison E Hansen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1396127957 PECOS PAC ID: 0446507974 Enrollment ID: I20180716001037 |
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