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1841424546

NPI Code Detail

MEDICARE: BEHAVIORAL SLEEP MEDICINE, LLC

MEDICARE: BEHAVIORAL SLEEP MEDICINE, LLC

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	225X00000X	Occupational Therapist
2	225XM0800X	Mental Health Occupational Therapist
3	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1841424546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL SLEEP MEDICINE, LLC

Provider Business Mailing Address
First Line	:	6895 BATTLE MOUNTAIN RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-1242
Country	:	US
Telephone Number	:	719-373-0051
Fax Number	:	719-373-0052

Provider Business Practice Location Address
First Line	:	1155 KELLY JOHNSON BLVD STE 111
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3957
Country	:	US
Telephone Number	:	719-373-0051
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. ROBERT N GLIDEWELL
Credential	:	PSYD
Telephone Number	:	719-239-7078

Provider Enumeration Date	:	05/08/2009
Last Update Date	:	05/30/2024

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Directions to “BEHAVIORAL SLEEP MEDICINE, LLC ” Practice Location

Language	Start Address	Practice Location

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