Healthcare Provider Details

I. General information

NPI: 1679002612
Provider Name (Legal Business Name): PINWHEEL PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2017
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 TEMPLETON GAP RD STE 212
COLORADO SPRINGS CO
80907-8714
US

IV. Provider business mailing address

6050 STETSON HILLS BLVD # 111
COLORADO SPRINGS CO
80923-3562
US

V. Phone/Fax

Practice location:
  • Phone: 719-208-6331
  • Fax: 719-423-6348
Mailing address:
  • Phone: 719-208-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4575
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4575
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number4575
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4575
License Number StateCO

VIII. Authorized Official

Name: DR. JENNIFER MARIE HILL
Title or Position: LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 719-208-6331