Organization Active NPI

Sara Honn Qualls PHD LLC

  • Adult Mental Health Clinic/Center
  • Colorado Springs, CO
National Provider Identifier
1184393738
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SARA HONN QUALLS PHD LLC
Practice address
10 E Monument St
Colorado Springs, CO 80903-1018
Phone
(719) 428-5025
Fax
(719) 896-5138
NPI assigned
Sep 8, 2021
Last updated
Sep 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Authorized official

Name
Dr. Sara Honn Qualls X, PHDNPI 1881792331
Title
Clinical Psychologist
Phone
(719) 428-5025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

10 E Monument St
Colorado Springs, CO 80903-1018

Mailing address

10 E Monument St
Colorado Springs, CO 80903-1018
Phone (719) 428-5025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210916000934 CO Part B Supplier - Clinic/Group Practice 2163829292 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1184393738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E MONUMENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031018",
            "telephone_number": "719-428-5025",
            "fax_number": "719-896-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E MONUMENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031018",
            "telephone_number": "719-428-5025",
            "fax_number": "719-896-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARA HONN QUALLS PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "QUALLS",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "HONN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "719-428-5025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "X",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.