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General NPI Number Information
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NPI Number | 1720248495
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Entity Type | Organization
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Legal Business Name | SOUTHWEST CONSULTING GROUP, INC.
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 2135 SOUTHGATE RD SUITE 210
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-2605
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Country | US
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Telephone | 719-633-7100
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Fax | 719-633-7170
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Provider Business Mailing Address
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Address Line | 2135 SOUTHGATE RD SUITE 210
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-2605
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Country | US
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Telephone | 719-633-7100
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Fax | 719-633-7170
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEWIS DENNIS KLEINSASSER
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Credential | PH.D.
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Telephone | 719-633-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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