Provider Demographics
NPI:1003377128
Name:LENTZ PSYCHOLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:LENTZ PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:719-551-9911
Mailing Address - Street 1:5855 LEHMAN DR STE 202
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3492
Mailing Address - Country:US
Mailing Address - Phone:719-551-9911
Mailing Address - Fax:719-596-9636
Practice Address - Street 1:5855 LEHMAN DR STE 202
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3492
Practice Address - Country:US
Practice Address - Phone:719-551-9911
Practice Address - Fax:719-596-9636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health