Provider Demographics
NPI:1598039174
Name:ACM PSYCHIATRIC CONSULTANTS, LLC
Entity Type:Organization
Organization Name:ACM PSYCHIATRIC CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARDIS
Authorized Official - Middle Name:CAPPRICE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-357-7617
Mailing Address - Street 1:4740 FLINTRIDGE DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4253
Mailing Address - Country:US
Mailing Address - Phone:719-357-7617
Mailing Address - Fax:719-344-2311
Practice Address - Street 1:4740 FLINTRIDGE DR
Practice Address - Street 2:SUITE 214
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4253
Practice Address - Country:US
Practice Address - Phone:719-357-7617
Practice Address - Fax:719-344-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42787261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO130289Medicare UPIN