Provider Demographics
NPI:1669084133
Name:TCLLLC
Entity type:Organization
Organization Name:TCLLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOUCKS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:720-563-1736
Mailing Address - Street 1:3107 W COLORADO AVE # 118
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-2040
Mailing Address - Country:US
Mailing Address - Phone:720-563-1736
Mailing Address - Fax:855-965-0935
Practice Address - Street 1:2822 W CUEHARRAS ST.
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904
Practice Address - Country:US
Practice Address - Phone:720-563-1736
Practice Address - Fax:855-965-0935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty