| Safeside Counseling, Llc | |
|
2993 Broadmoor Valley Rd Suite 105c Colorado Springs CO 80906-4471 | |
| (719) 244-3662 | |
| Not Available |
| Full Name | Safeside Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2993 Broadmoor Valley Rd, Colorado Springs, Colorado |
| Authorized Official Name and Position | Janae Nelson Lane (MANAGER) |
| Authorized Official Contact | 7192443662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Safeside Counseling, Llc Po Box 1085 Monument CO 80132-1085 Ph: (719) 244-3662 | Safeside Counseling, Llc 2993 Broadmoor Valley Rd Suite 105c Colorado Springs CO 80906-4471 Ph: (719) 244-3662 |
| NPI Number | 1679803993 |
|---|---|
| Provider Enumeration Date | 01/08/2010 |
| Last Update Date | 01/08/2010 |
| Medicare PECOS PAC ID | 0042461758 |
|---|---|
| Medicare Enrollment ID | O20121106000275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679803993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Janae Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023108198 PECOS PAC ID: 5597838755 Enrollment ID: I20080721000714 |
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