Raelee Eicke

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0004955 Issued in CO

Practice address

7730 N Union Blvd Ste 204
Colorado Springs, CO 80920-4083

Phone

(719) 323-3094

Fax

(719) 266-1773

NPI assigned

Jun 30, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
• CO HMO D-SNP
• CO HMO

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442
  Medicare reassignment NPD
• Authentic Life Counseling Colorado Springs

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1598308181
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1023491768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 N UNION BLVD STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204083",
            "telephone_number": "719-323-3094",
            "fax_number": "719-266-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 N UNION BLVD STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204083",
            "telephone_number": "719-323-3094",
            "fax_number": "719-266-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICKE",
        "first_name": "RAELEE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000169310",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Ehlers, PHARMD
• Rachael Carolyn Ehrle, PT, DPT
• Ehro Health, LLC
• Julie Eichelberger, LPC
• Katelyn Marie Eichner, MASSAGE THERAPIST
• Deona Jene Eickhoff, RN
• Emily Ann Eickstaedt, AGNP
• Allyse Eide, BCBA
• Cameron Avery Eide
• Jacqueline Eide

• Clinical Psychologist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.