| Gateway To Success, Pc | |
|
2429 S Prairie Ave Pueblo CO 81005-2886 | |
| (719) 564-5070 | |
| (719) 896-2874 |
| Full Name | Gateway To Success, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2429 S Prairie Ave, Pueblo, Colorado |
| Authorized Official Name and Position | Karen Morgenthaler (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7195645070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway To Success, Pc Po Box 1748 Canon City CO 81215-1748 Ph: (719) 564-5070 | Gateway To Success, Pc 2429 S Prairie Ave Pueblo CO 81005-2886 Ph: (719) 564-5070 |
| NPI Number | 1922348481 |
|---|---|
| Provider Enumeration Date | 02/21/2013 |
| Last Update Date | 12/13/2019 |
| Certification Date | 12/13/2019 |
| Medicare PECOS PAC ID | 3173885670 |
|---|---|
| Medicare Enrollment ID | O20180321001712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922348481 | NPI | - | NPPES |
| 98435264 | Medicaid | CO |
| Provider Name | Karen S Morgenthaler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043589823 PECOS PAC ID: 7517125131 Enrollment ID: I20120228000247 |
| Provider Name | Elisabeth A Sciotto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699027565 PECOS PAC ID: 8921250788 Enrollment ID: I20121201000047 |
| Provider Name | Kristina L Carrera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992079925 PECOS PAC ID: 8123248077 Enrollment ID: I20140929000368 |
| Provider Name | Cynthia R Souleret |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518210228 PECOS PAC ID: 0345553947 Enrollment ID: I20150724010333 |
| Provider Name | Katherine Derossett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134644594 PECOS PAC ID: 7214201102 Enrollment ID: I20170915000860 |
| Provider Name | Tricia Nicole Williamson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699193151 PECOS PAC ID: 4284960667 Enrollment ID: I20190723001838 |
| Provider Name | Nadine Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285163774 PECOS PAC ID: 6800226614 Enrollment ID: I20200420000163 |
| Provider Name | Brittany J Decoteau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770809980 PECOS PAC ID: 8527498104 Enrollment ID: I20200422001958 |
| Provider Name | Alan Donald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033693049 PECOS PAC ID: 7618358979 Enrollment ID: I20220718001648 |
| Provider Name | Karla Lee Scull |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316588445 PECOS PAC ID: 6305222621 Enrollment ID: I20221010002192 |
| Provider Name | Xaviera Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023589447 PECOS PAC ID: 4688037666 Enrollment ID: I20230823002659 |
| Provider Name | Alexandria Brook Davis-mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013617505 PECOS PAC ID: 5395106785 Enrollment ID: I20231007000493 |
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