Provider Demographics
NPI:1083354633
Name:NEW PEAKS NEUROPSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:NEW PEAKS NEUROPSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING CONTRACTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-444-3443
Mailing Address - Street 1:PO BOX 273336
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80527-3336
Mailing Address - Country:US
Mailing Address - Phone:303-444-3443
Mailing Address - Fax:970-221-3730
Practice Address - Street 1:777 29TH ST STE 200
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2316
Practice Address - Country:US
Practice Address - Phone:303-200-4780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty