Provider Demographics
NPI:1396058020
Name:SUNFLOWER PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:SUNFLOWER PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HINKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-930-8484
Mailing Address - Street 1:276 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7625
Mailing Address - Country:US
Mailing Address - Phone:719-930-8484
Mailing Address - Fax:719-375-5266
Practice Address - Street 1:524 N TEJON ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-4926
Practice Address - Country:US
Practice Address - Phone:719-930-8484
Practice Address - Fax:719-375-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3113103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC810702OtherMEDICARE PTAN