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SAMPLE SERVICES NPI 1700245578


NPI Information

NPI: 1700245578
Provider Name: SAMPLE SERVICES
Classification: Psychologist - 103TA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
606 MOUNTAIN VIEW AVE
LONGMONT, CO
ZIP 80501
Phone: (720) 684-6309
Get Directions

SAMPLE SERVICES is an addiction (substance use disorder) psychologist in Longmont, CO. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. SAMPLE SERVICES NPI is 1700245578. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

606 MOUNTAIN VIEW AVE
LONGMONT, CO
ZIP 80501-779
Phone: (720) 684-6309

The provider's authorized official is Carmen Sample .
The authorized official title is Ceo and has the following contact phone number (303) 523-8057.

The enumeration date for this NPI number is 2/22/2016 and was last updated on 1/31/2023.


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
1103TA0400XPsychologistAddiction (Substance Use Disorder)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
195109587MEDICAIDCOLORADO

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: 4/28/2024

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