BUCK JACK LLC (NPI# 1225642341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225642341 |
| Entity Type | Organization |
| Organization Name | BUCK JACK LLC |
| Practice Address |
8540 Scarborough Dr Ste 300 Colorado Springs CO 80920-7581 |
| Mailing Address |
685 Citadel Dr E Ste 580 Colorado Springs CO 80909-5381 |
| Practice Telephone | 7198220900 |
| Mailing Telephone | 7195970822 |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |
| Authorized Official Name | WILLIAM COLT (PRESIDENT) |
| Authorized Official Telephone | 7134106889 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 9000181601 | 05 |
| Other Name | Type Code |
|---|---|
| The Shandy Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212393 | Buck Jack LLC | Physical Therapist | Mountain View Core Knowledge School 890 Field Ave, Cannon City, CO 81212 | 2020-10-09 |
| 1912505116 | Buck Jack LLC | Behavioral Analyst | 1301 Fortino Blvd, Pueblo, CO 81008-2032 | 2020-10-12 |
| 1376141572 | Buck Jack LLC | Behavioral Analyst | 1321 S Prairie Ave, Pueblo, CO 81005-2307 | 2020-10-12 |
| 1568060754 | Buck Jack LLC | Behavioral Analyst | 830 Tenderfoot Hill Rd Ste 100, Colorado Springs, CO 80906-7372 | 2020-10-12 |
| 1730787920 | Buck Jack LLC | Behavioral Analyst | 917 E Moreno Ave Ste 150, Colorado Springs, CO 80903-4547 | 2020-10-12 |
| 1467050658 | Buck Jack LLC | Behavioral Analyst | 901 N Santa Fe Ave, Fountain, CO 80817-1738 | 2020-10-12 |
| 1104424423 | Buck Jack LLC | Behavioral Analyst | 3625 Citadel Dr S, Colorado Springs, CO 80909-5320 | 2020-10-09 |
| 1497353700 | Buck Jack LLC | Physical Therapist | 2233 Academy Pl Ste 201, Colorado Springs, CO 80909-1679 | 2020-10-09 |
| 1942808258 | Buck Jack LLC | Behavioral Analyst | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2020-10-09 |
| 1619575909 | Buck Jack LLC | Physical Therapist | 3901 E Yale Ave, Denver, CO 80210-6646 | 2020-10-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Buck Jack LLC | 419 South Tejon Appt. 309, Colorado Springs, CO 80903 |
| Street Address |
8540 SCARBOROUGH DR STE 300 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80920-7581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134420532 | Amy Nicole Losier | Occupational Therapist | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2010-11-16 |
| 1942808258 | Buck Jack LLC | Behavioral Analyst | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2020-10-09 |
| 1538766100 | Amy Shandy, Speech-language Pathologist, LLC | Behavioral Analyst | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2020-10-06 |
| 1063025187 | Buck Jack LLC | Psychologist | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7581 | 2020-08-28 |
| 1033770870 | Stephanie Aleen Rogers | Occupational Therapist | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2019-06-24 |
| 1093270514 | Courtney Elizabeth Klemme | Speech-Language Pathologist | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2019-02-08 |
| 1275098360 | Alexa Tovsen | Physical Therapist | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7581 | 2019-02-04 |
| 1831669514 | Hanna B Siler | Occupational Therapist | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7581 | 2018-11-26 |
| 1154840817 | Jacqueline Marie Mitchell | Occupational Therapist | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2017-09-13 |
| 1093236135 | Ashley Hamill | Speech-Language Pathologist | 8540 Scarborough Dr Ste 300, Colorado Springs, CO 80920-7519 | 2017-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463409 | Cynthia Cruz | Marriage & Family Therapist | 7710 N. Union, Ste 100b and 100c, Colorado Springs, CO 80920 | 2020-09-24 |
| 1851905178 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - Md, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-09-03 |
| 1114531431 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - Md, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1205440583 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - App, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1962015792 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - App, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-08-31 |
| 1194296491 | Kramer Dentistry Inc | Clinic/Center | 9290 Highland Ridge Heights Suite # 120, Colorado Springs, CO 80920 | 2018-12-12 |
| 1134602279 | Juliana Plucinik | Assistant Behavior Analyst | 7011 Campus Drive Suite 205, Colorado Springs, CO 80920 | 2018-09-14 |
| 1811473861 | Vsb Colorado Providers Pllc | Dentist | 1750 Telstar Drive, Suite 200, Colorado Springs, CO 80920 | 2018-07-12 |
| 1336637438 | Children's Hospital Colorado | General Acute Care Hospital | 4090 Briargate Parkway, Colorado Springs, CO 80920 | 2018-04-25 |
| Find all providers in zip 80920 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766466 | Lindsay Shaw | Psychologist | 9451 Palladium Hts # C416, Colorado Springs, CO 80920-1615 | 2020-09-24 |
| 1225506751 | Thrash & Associates Pllc | Psychologist | 224 E Willamette Ave # 8, Colorado Springs, CO 80903-1114 | 2018-11-02 |
| 1801375878 | Joan Dorothy Hemmer | Psychologist | 4879 Spanish Hts, Colorado Springs, CO 80906-5970 | 2018-08-10 |
| 1669963427 | James Lawrence Bixler | Psychologist | 4003 N Weber St Ste B2, Colorado Springs, CO 80907-4410 | 2018-05-28 |
| 1245759380 | Shanda Dawn Vaira | Psychologist | 3275 Pony Tracks Dr, Colorado Springs, CO 80922-1416 | 2017-09-10 |
| 1477080430 | Mountaineer Counseling and Consulting, LLC | Psychologist | 1843 Austin Bluffs Pkwy Ste 201, Colorado Springs, CO 80918-7857 | 2017-05-20 |
| 1083145858 | Jennifer Marie Hill | Psychologist | 3225 Templeton Gap Rd Ste 212, Colorado Springs, CO 80907-8714 | 2017-03-23 |
| 1780120725 | Katie Poe | Psychologist | 8424 Lundeen Pl, Colorado Springs, CO 80925-9588 | 2017-01-15 |
| 1851748016 | Kyle Green | Psychologist | 4356 Montebello Dr, Suite 25283, Colorado Springs, CO 80918-9998 | 2016-05-18 |
| 1417331075 | Diane Chew | Psychologist | 5245 Centennial Blvd Ste 200, Colorado Springs, CO 80919-4405 | 2015-07-14 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80920 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.