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1250 Karen Ln Woodland Park CO 80863-2455 | |
| (719) 360-0802 | |
| (719) 687-4801 |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1250 Karen Ln, Woodland Park, Colorado |
| Authorized Official Name and Position | Jamie Michelle Andersen (OWNER) |
| Authorized Official Contact | 7193600802 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1067 E Us Highway 24 # 231 Woodland Park CO 80863-2120 Ph: (719) 360-0802 | 1250 Karen Ln Woodland Park CO 80863-2455 Ph: (719) 360-0802 |
| NPI Number | 1841712080 |
|---|---|
| Provider Enumeration Date | 07/10/2017 |
| Last Update Date | 05/30/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 8123460839 |
|---|---|
| Medicare Enrollment ID | O20240528000614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841712080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Jamie M Andersen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013085026 PECOS PAC ID: 3375085608 Enrollment ID: I20240603000872 |
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