Provider Demographics
NPI:1194356923
Name:MELISSA M. RACHO, PH.D. PSYCHOTHERAPY & PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:MELISSA M. RACHO, PH.D. PSYCHOTHERAPY & PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:RACHO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:720-209-1815
Mailing Address - Street 1:6145 METHUSELA RD
Mailing Address - Street 2:
Mailing Address - City:MANITOU SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80829-3825
Mailing Address - Country:US
Mailing Address - Phone:719-726-1149
Mailing Address - Fax:
Practice Address - Street 1:3462 BRIARGATE BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4168
Practice Address - Country:US
Practice Address - Phone:719-726-1149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty