Healthcare Provider Details

I. General information

NPI: 1366607707
Provider Name (Legal Business Name): WILLIAM CLANCY PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BILL CLANCY PSYD

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 ORCHARD PKWY
WESTMINSTER CO
80023-9206
US

IV. Provider business mailing address

PO BOX 800022
KANSAS CITY MO
64180-0022
US

V. Phone/Fax

Practice location:
  • Phone: 720-321-8950
  • Fax: 720-321-8969
Mailing address:
  • Phone: 800-953-0104
  • Fax: 303-765-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3551
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: