| Milestone Psychiatry Inc | |
|
5615 Constitution Ave Colorado Springs CO 80915-1218 | |
| (719) 465-2819 | |
| (719) 465-2975 |
| Full Name | Milestone Psychiatry Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5615 Constitution Ave, Colorado Springs, Colorado |
| Authorized Official Name and Position | Lewis Swarthout (OWNER) |
| Authorized Official Contact | 7194652975 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milestone Psychiatry Inc 5615 Constitution Ave Colorado Springs CO 80915-1218 Ph: (719) 465-2819 | Milestone Psychiatry Inc 5615 Constitution Ave Colorado Springs CO 80915-1218 Ph: (719) 465-2819 |
| NPI Number | 1871123869 |
|---|---|
| Provider Enumeration Date | 01/19/2020 |
| Last Update Date | 12/06/2023 |
| Certification Date | 12/06/2023 |
| Medicare PECOS PAC ID | 5092196485 |
|---|---|
| Medicare Enrollment ID | O20220716000014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871123869 | NPI | - | NPPES |
| 9000193560 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Kayla Previdi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619416765 PECOS PAC ID: 3678842739 Enrollment ID: I20170705001013 |
| Provider Name | Lewis W Swarthout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437593894 PECOS PAC ID: 3971742867 Enrollment ID: I20200601001852 |
| Provider Name | Kristin Nicole Magnuson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831842525 PECOS PAC ID: 8921485772 Enrollment ID: I20221024002584 |
| Provider Name | Harisa Beba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801581772 PECOS PAC ID: 6305201914 Enrollment ID: I20231114000404 |
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