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POUDRE VALLEY MEDICAL GROUP LLC NPI 1609485648


NPI Information

NPI: 1609485648
Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
175 S UNION BLVD STE 240
COLORADO SPRINGS, CO
ZIP 80910
Phone: (719) 365-6300
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POUDRE VALLEY MEDICAL GROUP, LLC is a clinical neuropsychologist in Colorado Springs, CO. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. POUDRE VALLEY MEDICAL GROUP, LLC NPI is 1609485648. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

175 S UNION BLVD STE 240
COLORADO SPRINGS, CO
ZIP 80910-125
Phone: (719) 365-6300
Fax: (719) 365-6094

The provider's authorized official is Jana Conroy .
The authorized official title is Credentialing Manager and has the following contact phone number (970) 624-4443.

The enumeration date for this NPI number is 7/27/2020 and was last updated on 7/27/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103G00000XClinical NeuropsychologistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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