Healthcare Provider Details

I. General information

NPI: 1639232598
Provider Name (Legal Business Name): CAROL ANN BARTON-GODEC PSYCHIATRIC CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6465 GREENWOOD PLAZA BLVD SUITE 300, CO030-1000
CENTENNIAL CO
80111-4905
US

IV. Provider business mailing address

5606 DUSTY CHAPS DR
COLORADO SPRINGS CO
80922-4142
US

V. Phone/Fax

Practice location:
  • Phone: 888-795-7975
  • Fax: 303-267-3179
Mailing address:
  • Phone: 719-550-9202
  • Fax: 719-550-8933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number75151
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: