| Psyke, Llc | |
|
104 South Main Street Mancos CO 81328 | |
| (970) 759-7328 | |
| (970) 512-7848 |
| Full Name | Psyke, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 104 South Main Street, Mancos, Colorado |
| Authorized Official Name and Position | Polly Sikora (OWNER/PROVIDER) |
| Authorized Official Contact | 9707597328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psyke, Llc 41263 Road G Mancos CO 81328 Ph: (970) 759-7328 | Psyke, Llc 104 South Main Street Mancos CO 81328 Ph: (970) 759-7328 |
| NPI Number | 1386134112 |
|---|---|
| Provider Enumeration Date | 05/17/2018 |
| Last Update Date | 05/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386134112 | NPI | - | NPPES |
| 881295 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0005583 (Colorado) | Primary |
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