Provider Demographics
NPI:1598156994
Name:SUMMIT PSYCHOLOGICAL ASSESSMENT & CONSULTATION
Entity Type:Organization
Organization Name:SUMMIT PSYCHOLOGICAL ASSESSMENT & CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKOFSKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-641-3748
Mailing Address - Street 1:7710 N UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7710 N UNION BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4030
Practice Address - Country:US
Practice Address - Phone:719-641-3748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-07
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty