Healthcare Provider Details

I. General information

NPI: 1508710955
Provider Name (Legal Business Name): WILSON FRANCIS CLAUSSEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3239 INDEPENDENCE RD
CANON CITY CO
81212-9380
US

IV. Provider business mailing address

2006 E 15TH ST
PUEBLO CO
81001-2826
US

V. Phone/Fax

Practice location:
  • Phone: 719-275-7650
  • Fax:
Mailing address:
  • Phone: 303-919-9329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0008565
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: