Provider Demographics
NPI:1720248495
Name:SOUTHWEST CONSULTING GROUP, INC.
Entity Type:Organization
Organization Name:SOUTHWEST CONSULTING GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:KLEINSASSER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-633-7100
Mailing Address - Street 1:2135 SOUTHGATE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-2605
Mailing Address - Country:US
Mailing Address - Phone:719-633-7100
Mailing Address - Fax:719-633-7170
Practice Address - Street 1:2135 SOUTHGATE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-2605
Practice Address - Country:US
Practice Address - Phone:719-633-7100
Practice Address - Fax:719-633-7170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty