Provider Demographics
NPI:1508183229
Name:UNGVARSKY, JAMES JOHN (PSYD, LMFT)
Entity Type:Individual
Prefix:PROF
First Name:JAMES
Middle Name:JOHN
Last Name:UNGVARSKY
Suffix:
Gender:M
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4773 CHAPARRAL RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1442
Mailing Address - Country:US
Mailing Address - Phone:719-380-9815
Mailing Address - Fax:
Practice Address - Street 1:990 PINON RANCH VW
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3309
Practice Address - Country:US
Practice Address - Phone:719-548-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT 459106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist