Provider Demographics
NPI:1679002612
Name:PINWHEEL PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:PINWHEEL PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:PINWHEEL PSYCHOLOGICAL SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-208-6331
Mailing Address - Street 1:6050 STETSON HILLS BLVD # 111
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3562
Mailing Address - Country:US
Mailing Address - Phone:719-208-6331
Mailing Address - Fax:
Practice Address - Street 1:3225 TEMPLETON GAP RD STE 212
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8714
Practice Address - Country:US
Practice Address - Phone:719-208-6331
Practice Address - Fax:719-423-6348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-04
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4575103T00000X, 103TB0200X, 103TC2200X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty