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General NPI Number Information
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NPI Number | 1386861516
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Entity Type | Organization
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Legal Business Name | STEEL CITY CONSULTANTS
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 803 W 4TH STREET SUITE U AND F
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City | PUEBLO
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State | CO
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Zip | 81003
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Country | US
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Telephone | 719-545-3814
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Fax | 719-924-8610
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Provider Business Mailing Address
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Address Line | 803 W 4TH STREET SUITE F
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City | PUEBLO
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State | CO
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Zip | 81003
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Country | US
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Telephone | 719-545-3814
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Fax | 719-924-8610
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. MATTHEW MEJIA
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Credential | PSYD
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Telephone | 719-545-3814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3759
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License Number State | CO
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