| Kaleidoscope Center PLLC | |
|
777 S Wadsworth Blvd Lakewood CO 80226-4300 | |
| (720) 514-9925 | |
| (888) 494-4199 |
| Full Name | Kaleidoscope Center PLLC |
|---|---|
| Speciality | Psychologist |
| Location | 777 S Wadsworth Blvd, Lakewood, Colorado |
| Authorized Official Name and Position | Shoshana Aal (OWNER) |
| Authorized Official Contact | 7205149925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaleidoscope Center PLLC 777 S Wadsworth Blvd Lakewood CO 80226-4300 Ph: (720) 514-9925 | Kaleidoscope Center PLLC 777 S Wadsworth Blvd Lakewood CO 80226-4300 Ph: (720) 514-9925 |
| NPI Number | 1952921009 |
|---|---|
| Provider Enumeration Date | 04/18/2020 |
| Last Update Date | 07/02/2025 |
| Certification Date | 07/02/2025 |
| Medicare PECOS PAC ID | 4486085347 |
|---|---|
| Medicare Enrollment ID | O20200508000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952921009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (NU) | Primary |
| Provider Name | Shoshana Nicole Aal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093982704 PECOS PAC ID: 5395176259 Enrollment ID: I20200508000509 |
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