MEDICARE: PARACLAYSIS

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
1	251S00000X	Community/Behavioral Health Agency	675	CO

General Provider Information

NPI Number	:	1437208154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARACLAYSIS

Provider Business Mailing Address
First Line	:	7025 COTTON DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6389
Country	:	US
Telephone Number	:	719-210-9744
Fax Number	:	719-302-2356

Provider Business Practice Location Address
First Line	:	3110 BOYCHUCK AVE
Second Line	:	SUITE K
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-1026
Country	:	US
Telephone Number	:	719-210-9744
Fax Number	:	719-302-2356

Authorized Official
Title or Position	:	PRESIDENT, BOARD OF DIRECTORS
Name	:	MR. JAMES L. BIXLER
Credential	:	LMFT
Telephone Number	:	719-210-9744

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	08/22/2020

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