Tracie A Nicoll Phd | |
245 E Cheyenne Mountain Blvd Colorado Springs CO 80906-3719 | |
(719) 232-5223 | |
(719) 362-4439 |
Full Name | Tracie A Nicoll Phd |
---|---|
Speciality | Clinic/Center |
Location | 245 E Cheyenne Mountain Blvd, Colorado Springs, Colorado |
Authorized Official Name and Position | Tracie A Nicoll (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 7192325223 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Tracie A Nicoll Phd 245 E Cheyenne Mountain Blvd Colorado Springs CO 80906-3719 Ph: (719) 232-5223 | Tracie A Nicoll Phd 245 E Cheyenne Mountain Blvd Colorado Springs CO 80906-3719 Ph: (719) 232-5223 |
NPI Number | 1194331215 |
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Provider Enumeration Date | 09/23/2020 |
Last Update Date | 09/23/2020 |
Certification Date | 09/23/2020 |
Medicare PECOS PAC ID | 4284044629 |
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Medicare Enrollment ID | O20201113000768 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194331215 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Tracie A Nicoll |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1558844225 PECOS PAC ID: 7911250782 Enrollment ID: I20181024001235 |
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