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NPI Code Detail

MEDICARE: THE CENTER FOR PLAY THERAPY

MEDICARE: THE CENTER FOR PLAY THERAPY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent Psychologist
2101Y00000XCounselor

General Provider Information

NPI Number : 1184310245
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CENTER FOR PLAY THERAPY
Provider Business Mailing Address
First Line : 4820 RUSINA RD STE A
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-8127
Country : US
Telephone Number : 504-234-9433
Fax Number :
Provider Business Practice Location Address
First Line : 4820 RUSINA RD STE A
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-8127
Country : US
Telephone Number : 719-465-1977
Fax Number :
Authorized Official
Title or Position : CLINICAL PSYCHOLOGIST
Name : KIERSTEN VICTORIA SIPPIO
Credential : DR
Telephone Number : 504-234-9433
Provider Enumeration Date : 04/12/2023
Last Update Date : 04/12/2023

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Directions to “THE CENTER FOR PLAY THERAPY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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