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NPI Code Detail

MEDICARE: WHOLE KIDS CO. PLLC

MEDICARE: WHOLE KIDS CO. PLLC
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
1103K00000XBehavior Analyst1-16-22433CO
2101YP2500XProfessional Counselor0013986CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932617792
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHOLE KIDS CO. PLLC
Provider Business Mailing Address
First Line : 11681 VOYAGER PKWY STE 150
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80921-3864
Country : US
Telephone Number : 719-344-9342
Fax Number : 719-375-3531
Provider Business Practice Location Address
First Line : 11681 VOYAGER PKWY STE 150
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80921-3864
Country : US
Telephone Number : 719-344-9342
Fax Number : 719-375-3531
Authorized Official
Title or Position : OWNER AND CLINICAL DIRECTOR
Name : MRS. CHRISTIE GAIL COLLINS
Credential : MA, LPC, BCBA
Telephone Number : 469-223-1579
Provider Enumeration Date : 01/15/2018
Last Update Date : 04/19/2021

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