| Mh1r | |
|
117 Ellendale St Castle Rock CO 80104-8010 | |
| (303) 910-9693 | |
| Not Available |
| Full Name | Mh1r |
|---|---|
| Speciality | Social Worker |
| Location | 117 Ellendale St, Castle Rock, Colorado |
| Authorized Official Name and Position | Jamie M Zornes (PRESIDENT) |
| Authorized Official Contact | 3039109693 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mh1r 117 Ellendale St Castle Rock CO 80104-8801 Ph: (303) 910-9693 | Mh1r 117 Ellendale St Castle Rock CO 80104-8010 Ph: (303) 910-9693 |
| NPI Number | 1467124511 |
|---|---|
| Provider Enumeration Date | 09/28/2021 |
| Last Update Date | 02/15/2023 |
| Certification Date | 02/15/2023 |
| Medicare PECOS PAC ID | 7719352848 |
|---|---|
| Medicare Enrollment ID | O20230403002708 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467124511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jamie M Zornes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790243236 PECOS PAC ID: 6103166582 Enrollment ID: I20190321001063 |
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