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General NPI Number Information
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NPI Number | 1316368996
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 12/26/2013
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 420 E 58TH AVE STE 210
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City | DENVER
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State | CO
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Zip | 80216-1400
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Country | US
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Telephone | 720-854-0262
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Fax | 720-854-0263
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Provider Business Mailing Address
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Address Line | 420 E 58TH AVE STE 210
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City | DENVER
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State | CO
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Zip | 80216-1400
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Country | US
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Telephone | 720-854-0262
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Fax | 720-854-0263
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE QUINN HIDALGO
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Credential | MA, LPC
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Telephone | 720-937-9758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 2519
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License Number State | CO
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