Neurocognitive Clinic | |
1920 Thomes Ave Ste 310 Cheyenne WY 82001-3545 | |
(307) 220-9099 | |
(866) 287-5634 |
Full Name | Neurocognitive Clinic |
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Speciality | Psychologist |
Location | 1920 Thomes Ave Ste 310, Cheyenne, Wyoming |
Authorized Official Name and Position | Steven D Newman (PRESIDENT) |
Authorized Official Contact | 3072209099 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neurocognitive Clinic 6050 Stetson Hills Blvd Colorado Springs CO 80923-3562 Ph: (307) 220-9099 | Neurocognitive Clinic 1920 Thomes Ave Ste 310 Cheyenne WY 82001-3545 Ph: (307) 220-9099 |
NPI Number | 1619335627 |
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Provider Enumeration Date | 02/04/2016 |
Last Update Date | 05/23/2022 |
Certification Date | 05/23/2022 |
Medicare PECOS PAC ID | 2062705098 |
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Medicare Enrollment ID | O20160727002607 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619335627 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | 395 (Wyoming) | Primary |
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