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NPI Code Detail

MEDICARE: JESSIE JAMES PAULEY PSYD, LP, CMPC

MEDICARE:   JESSIE JAMES PAULEY  PSYD, LP, CMPC
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
1103T00000XPsychologist6167CO

General Provider Information

NPI Number : 1902381288
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSIE JAMES PAULEY PSYD, LP, CMPC
Provider Business Mailing Address
First Line : 226 REMINGTON ST UNIT 1
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-7115
Country : US
Telephone Number : 720-443-2388
Fax Number :
Provider Business Practice Location Address
First Line : 226 REMINGTON ST UNIT 1
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-7115
Country : US
Telephone Number : 720-443-2388
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2018
Last Update Date : 09/24/2024

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Directions to “ JESSIE JAMES PAULEY PSYD, LP, CMPC” Practice Location

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