Provider Demographics
NPI:1417326232
Name:PSYCHOLOGICAL COUNSELING & CONSULTING
Entity Type:Organization
Organization Name:PSYCHOLOGICAL COUNSELING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STAUDENMAYER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-758-8934
Mailing Address - Street 1:10332 TOMICHI DR
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116-8533
Mailing Address - Country:US
Mailing Address - Phone:303-758-8934
Mailing Address - Fax:
Practice Address - Street 1:10332 TOMICHI DR
Practice Address - Street 2:
Practice Address - City:FRANKTOWN
Practice Address - State:CO
Practice Address - Zip Code:80116-8533
Practice Address - Country:US
Practice Address - Phone:303-758-8934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO684103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty