Pickett Psychological Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PICKETT PSYCHOLOGICAL SERVICES, LLC

Practice address

100 W. Bennett Avenue
Cripple Creek, CO 80813

Phone

(719) 598-3585

NPI assigned

Aug 24, 2022

Organization subpart

No

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

Authorized official

Name

Clinton Pickett

Title

Owner

Phone

(832) 509-7564

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Pickett Psychological Services, LLC

  • Clinical Psychologist
  • Lakewood, CO
  • NPI 1487412060

  O20211006000900

  Same enrollment
• Pickett Psychological Services, LLC

  • Clinical Psychologist
  • Colorado Springs, CO
  • NPI 1598434300

  O20211006000900

  Same enrollment
• Pickett Psychological Services, LLC

  • Clinical Psychologist
  • Colorado Springs, CO
  • NPI 1730967712

  O20211006000900

  Same enrollment
• Pickett Psychological Services, LLC

  • Clinical Psychologist
  • Lakewood, CO
  • NPI 1871481549

  O20211006000900

  Same enrollment

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1730808692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 LAKE PLAZA DR STE 255",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W. BENNETT AVENUE",
            "city": "CRIPPLE CREEK",
            "state": "CO",
            "postal_code": "80813",
            "telephone_number": "719-598-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICKETT PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "PICKETT",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-509-7564"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Leadley, DDS
• Sadie Ann Miller
• Whitney Oden
• Peak Vista Community Health Centers
• Alicia Nicole Petri
• Poudre Valley Medical Group, LLC
• Premier Rural Family Medical & Dental Care, LLC
• Robert Paul Reid, M.D.
• Root Groove, PLLC
• Jill Elaine Saylor, FNP-BC, NP-C

• Clinical Psychologist in Cripple Creek, CO
• Providers in Cripple Creek, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.