Healthcare Provider Details

I. General information

NPI: 1922725142
Provider Name (Legal Business Name): BRANDY LYNN LOCKHART REGISTERED PSYCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7660 GODDARD ST STE 234
COLORADO SPRINGS CO
80920-8231
US

IV. Provider business mailing address

6660 DELMONICO DR STE D210
COLORADO SPRINGS CO
80919
US

V. Phone/Fax

Practice location:
  • Phone: 719-480-8848
  • Fax:
Mailing address:
  • Phone: 719-480-8848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0012910
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: