| Peak Therapeutic Inc | |
|
6760 Corporate Dr Ste 140 Colorado Springs CO 80919-5910 | |
| (951) 837-3722 | |
| (719) 631-0720 |
| Full Name | Peak Therapeutic Inc |
|---|---|
| Speciality | Psychologist |
| Location | 6760 Corporate Dr Ste 140, Colorado Springs, Colorado |
| Authorized Official Name and Position | Kevin Richard Bogstad (OWNER) |
| Authorized Official Contact | 9518373722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peak Therapeutic Inc 6760 Corporate Dr Ste 140 Colorado Springs CO 80919-5910 Ph: (951) 837-3722 | Peak Therapeutic Inc 6760 Corporate Dr Ste 140 Colorado Springs CO 80919-5910 Ph: (951) 837-3722 |
| NPI Number | 1053896415 |
|---|---|
| Provider Enumeration Date | 10/01/2018 |
| Last Update Date | 02/21/2022 |
| Certification Date | 02/21/2022 |
| Medicare PECOS PAC ID | 8224404371 |
|---|---|
| Medicare Enrollment ID | O20221014001927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053896415 | NPI | - | NPPES |
| 9000155112 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Kevin Richard Bogstad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124193180 PECOS PAC ID: 1951777002 Enrollment ID: I20240223002005 |
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