Provider Demographics
NPI:1629343728
Name:PRAXIS PSYCHOTHERAPY AND ASSESSMENTS
Entity Type:Organization
Organization Name:PRAXIS PSYCHOTHERAPY AND ASSESSMENTS
Other - Org Name:PRAXIS PSYCHOLOGICAL EVALUATIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-650-4389
Mailing Address - Street 1:4302 HIGH FOREST RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-2026
Mailing Address - Country:US
Mailing Address - Phone:719-650-4389
Mailing Address - Fax:
Practice Address - Street 1:3107 W COLORADO AVE # 158
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-2088
Practice Address - Country:US
Practice Address - Phone:719-650-4389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3651103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty