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General NPI Number Information
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NPI Number | 1528498078
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Entity Type | Organization
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Legal Business Name | ARKANSAS PEAK PSYCHOLOGICAL SERVICES, PPLC
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Dates
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Enumeration Date | 11/20/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 503 N MAIN ST SUITE 326
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City | PUEBLO
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State | CO
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Zip | 81003-3130
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Country | US
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Telephone | 720-291-8915
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Fax | 719-635-9631
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Provider Business Mailing Address
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Address Line | PO BOX 1268
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City | COLORADO SPRINGS
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State | CO
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Zip | 80901-1268
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Country | US
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Telephone | 720-291-8915
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Fax | 719-635-8631
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DAVID R BENSON
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Credential | PH.D
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Telephone | 720-291-8915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0002358
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License Number State | CO
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