Provider Demographics
NPI:1295227262
Name:CONNECTIONS CLINICAL & CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:CONNECTIONS CLINICAL & CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHARGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-471-3005
Mailing Address - Street 1:10 BOULDER CRESCENT ST STE 204D
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3355
Mailing Address - Country:US
Mailing Address - Phone:719-471-3005
Mailing Address - Fax:719-208-3293
Practice Address - Street 1:10 BOULDER CRESCENT ST STE 204D
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3355
Practice Address - Country:US
Practice Address - Phone:719-471-3005
Practice Address - Fax:719-208-3293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0003490101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO533512Medicaid