| Monumental Experiences Pllc | |
|
7660 Goddard St Ste 234 Colorado Springs CO 80920-8231 | |
| (719) 600-3011 | |
| (303) 532-5079 |
| Full Name | Monumental Experiences Pllc |
|---|---|
| Speciality | Counselor |
| Location | 7660 Goddard St Ste 234, Colorado Springs, Colorado |
| Authorized Official Name and Position | Abigail W Lavoo (MANAGER/ADMINISTRATOR) |
| Authorized Official Contact | 7196003011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monumental Experiences Pllc 6660 Delmonico Dr Suite D 210 Colorado Springs CO 80919 Ph: (719) 480-8848 | Monumental Experiences Pllc 7660 Goddard St Ste 234 Colorado Springs CO 80920-8231 Ph: (719) 600-3011 |
| NPI Number | 1770250300 |
|---|---|
| Provider Enumeration Date | 08/23/2021 |
| Last Update Date | 08/30/2021 |
| Certification Date | 08/30/2021 |
| Medicare PECOS PAC ID | 9436594215 |
|---|---|
| Medicare Enrollment ID | O20240303000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770250300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Abigail W Lavoo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063425122 PECOS PAC ID: 0345685129 Enrollment ID: I20240303000163 |
| Provider Name | Emily E Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194350603 PECOS PAC ID: 2163869082 Enrollment ID: I20240327000352 |
| Provider Name | Lisa Pantano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417218363 PECOS PAC ID: 7214376896 Enrollment ID: I20240416000425 |
| Provider Name | Christy C Ball |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427714716 PECOS PAC ID: 6406298256 Enrollment ID: I20240523003987 |
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