Healthcare Provider Details

I. General information

NPI: 1386305548
Provider Name (Legal Business Name): COMPASSIONATE BEHAVIORAL MEDICINE CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2022
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S COLORADO BLVD BLDG 1-2000
DENVER CO
80222-7910
US

IV. Provider business mailing address

2932 ROSS CLARK CIRCLE UNIT 330
DOTHAN AL
36301
US

V. Phone/Fax

Practice location:
  • Phone: 720-776-2916
  • Fax: 720-815-0354
Mailing address:
  • Phone: 334-954-1340
  • Fax: 334-851-2961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANGELA DAWKINS
Title or Position: MEMBER/PROVIDER
Credential: ARNP
Phone: 334-954-1340