Provider Demographics
NPI:1790252179
Name:LET'S EXPLORE PSYCHOLOGICAL & COUNSELING SERVICES
Entity Type:Organization
Organization Name:LET'S EXPLORE PSYCHOLOGICAL & COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:SIAN
Authorized Official - Last Name:MARGULIES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-642-3029
Mailing Address - Street 1:300 BOARDWALK DR UNIT 5A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3093
Mailing Address - Country:US
Mailing Address - Phone:301-642-3029
Mailing Address - Fax:970-223-2324
Practice Address - Street 1:300 BOARDWALK DR UNIT 5A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3093
Practice Address - Country:US
Practice Address - Phone:301-642-3029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
12129278OtherCAQH
CO49825003Medicaid