| Neurofeedback Colorado Springs, Inc. | |
|
1283 Kelly Johnson Blvd Colorado Springs CO 80920-3925 | |
| (719) 639-2928 | |
| (719) 203-6847 |
| Full Name | Neurofeedback Colorado Springs, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1283 Kelly Johnson Blvd, Colorado Springs, Colorado |
| Authorized Official Name and Position | Emily Inman (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7122090399 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurofeedback Colorado Springs, Inc. 1283 Kelly Johnson Blvd Colorado Springs CO 80920-3925 Ph: (719) 639-2928 | Neurofeedback Colorado Springs, Inc. 1283 Kelly Johnson Blvd Colorado Springs CO 80920-3925 Ph: (719) 639-2928 |
| NPI Number | 1972048098 |
|---|---|
| Provider Enumeration Date | 12/28/2016 |
| Last Update Date | 12/18/2020 |
| Certification Date | 12/18/2020 |
| Medicare PECOS PAC ID | 0446660575 |
|---|---|
| Medicare Enrollment ID | O20201102000226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972048098 | NPI | - | NPPES |
| Provider Name | Emily Ann Inman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780935882 PECOS PAC ID: 1052549607 Enrollment ID: I20140106001106 |
| Provider Name | Gabriella Stephanie Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497446942 PECOS PAC ID: 0840657227 Enrollment ID: I20230530001743 |
| Provider Name | Bailey Noel Westerfield Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306351440 PECOS PAC ID: 7113366295 Enrollment ID: I20240423000634 |
| Provider Name | Jose Luis Tapia-fuselier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760962955 PECOS PAC ID: 0143662148 Enrollment ID: I20240522001926 |
| Provider Name | Nadine Marie Doughty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275086605 PECOS PAC ID: 6507208303 Enrollment ID: I20240524001533 |
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