Provider Demographics
NPI:1740934280
Name:A CLEAR VIEW-RACETTE PSYCHOLOGICAL
Entity type:Organization
Organization Name:A CLEAR VIEW-RACETTE PSYCHOLOGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:RACETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-203-2894
Mailing Address - Street 1:1802 CHAPEL HILLS DR STE G
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3736
Mailing Address - Country:US
Mailing Address - Phone:719-203-2894
Mailing Address - Fax:719-982-7845
Practice Address - Street 1:1802 CHAPEL HILLS DR STE G
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3736
Practice Address - Country:US
Practice Address - Phone:719-203-2894
Practice Address - Fax:719-982-7845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty