Stephen P Street Pllc | |
4657 W. 20th Street Unit B Greeley CO 80634 | |
(970) 405-3438 | |
Not Available |
Full Name | Stephen P Street Pllc |
---|---|
Speciality | Counselor |
Location | 4657 W. 20th Street, Greeley, Colorado |
Authorized Official Name and Position | Stephen Street (OWNER) |
Authorized Official Contact | 9704053438 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Stephen P Street Pllc 9119 18th Street Greeley CO 80634 Ph: (970) 405-3438 | Stephen P Street Pllc 4657 W. 20th Street Unit B Greeley CO 80634 Ph: (970) 405-3438 |
NPI Number | 1407413727 |
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Provider Enumeration Date | 05/22/2019 |
Last Update Date | 05/22/2019 |
Medicare PECOS PAC ID | 4789029182 |
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Medicare Enrollment ID | O20240226000779 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407413727 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Stephen P Street |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1992040307 PECOS PAC ID: 5698110096 Enrollment ID: I20240401002492 |
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