| The Compassion Collaborative, Llc | |
|
5225 N Academy Blvd Ste 105 Colorado Springs CO 80918-4097 | |
| (719) 357-7504 | |
| (719) 357-7504 |
| Full Name | The Compassion Collaborative, Llc |
|---|---|
| Speciality | Counselor |
| Location | 5225 N Academy Blvd Ste 105, Colorado Springs, Colorado |
| Authorized Official Name and Position | Haley Wise (LICENSED PROFESSIONAL COUNSELOR, OW) |
| Authorized Official Contact | 7193577504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Compassion Collaborative, Llc 5225 N Academy Blvd Ste 105 Colorado Springs CO 80918-4097 Ph: (719) 357-7504 | The Compassion Collaborative, Llc 5225 N Academy Blvd Ste 105 Colorado Springs CO 80918-4097 Ph: (719) 357-7504 |
| NPI Number | 1669110557 |
|---|---|
| Provider Enumeration Date | 05/22/2022 |
| Last Update Date | 11/06/2023 |
| Certification Date | 11/06/2023 |
| Medicare PECOS PAC ID | 7911343173 |
|---|---|
| Medicare Enrollment ID | O20240311000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669110557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Haley Ashten Wise |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487208849 PECOS PAC ID: 8820434087 Enrollment ID: I20240311000392 |
| Provider Name | Kirsten Elizabeth Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063063550 PECOS PAC ID: 7517305881 Enrollment ID: I20240404004208 |
| Provider Name | Patrick J Holloman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902590516 PECOS PAC ID: 7911449731 Enrollment ID: I20240607003534 |
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