| Katie's Way Colorado Springs, Pllc | |
|
630 Southpointe Ct Ste 105 Colorado Springs CO 80906-3800 | |
| (719) 249-8638 | |
| (719) 249-8592 |
| Full Name | Katie's Way Colorado Springs, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 630 Southpointe Ct Ste 105, Colorado Springs, Colorado |
| Authorized Official Name and Position | Kelly Rae Johnson (CREDENTIALING DIRECTOR) |
| Authorized Official Contact | 7853206616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katie's Way Colorado Springs, Pllc 720 Poyntz Ave Manhattan KS 66502-6355 Ph: (785) 320-6616 | Katie's Way Colorado Springs, Pllc 630 Southpointe Ct Ste 105 Colorado Springs CO 80906-3800 Ph: (719) 249-8638 |
| NPI Number | 1073226858 |
|---|---|
| Provider Enumeration Date | 12/27/2022 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Medicare PECOS PAC ID | 8022549278 |
|---|---|
| Medicare Enrollment ID | O20240930001522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073226858 | NPI | - | NPPES |
| Provider Name | Brian Seavey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770651002 PECOS PAC ID: 6103922000 Enrollment ID: I20070626000406 |
| Provider Name | Rhonda Sims |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043477649 PECOS PAC ID: 1658425301 Enrollment ID: I20170602001780 |
| Provider Name | Dustin Halliwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447601463 PECOS PAC ID: 0345617171 Enrollment ID: I20221107002798 |
| Provider Name | Kirk Stoner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437844909 PECOS PAC ID: 6709230113 Enrollment ID: I20241230000032 |
| Provider Name | Caleb Lee Jordan |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1619361904 PECOS PAC ID: 2567771249 Enrollment ID: I20241230000855 |
| Provider Name | Aryn Andersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689235400 PECOS PAC ID: 8527453729 Enrollment ID: I20250327003485 |
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