Institute For Clinical Neurosciences

LBN: Icn Pllc
Institute For Clinical Neurosciences is an health care organization with primary practice located at 255 Canyon Blvd Ste 300-F , Boulder CO 80302-4979. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as the primary health care specialty. Icn Pllc can be contacted via phone (972) 570-8200, or through Gant, Bobby Lee via phone (720) 552-2995.

Contact Information

Primary practice address
255 Canyon Blvd Ste 300-F Boulder CO 80302-4979
Phone: (972) 570-8200
Fax: (972) 402-5621
Website:
Map and Directions
Authorized official contact:
Name: Gant, Bobby Lee PHD
Phone: (720) 552-2995

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2998 Colorado

Profile Details

NPI number 1487192076
LBN Legal business name Icn Pllc
DBA Doing business as Institute For Clinical Neurosciences
Authorized official Gant, Bobby Lee PHD
Entity Organization
Organization subpart 1 No
Enumeration date Feb 3rd, 2017
Last updated Jan 2nd, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487192076 NPPES
Colorado MEDICAID 9000167953

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