Pendleton, Mark G

Pendleton, Mark G is an sole proprietor health care provider with primary practice located at 3015 47Th Street Suite E-3 , Boulder CO 80301-5437. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Rehabilitation. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Pendleton, Mark G can be contacted via phone (303) 444-6335.

Contact Information

Primary practice address
3015 47Th Street Suite E-3 Boulder CO 80301-5437
Phone: (303) 444-6335
Fax: (303) 443-9641
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 797 Colorado
Behavioral Health & Social Service Providers / Clinical 103TC0700X 797 Colorado
Behavioral Health & Social Service Providers / Forensic 103TF0200X 797 Colorado
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X 797 Colorado

Profile Details

NPI number 1992776678
LBN Legal business name Pendleton, Mark G
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2006
Last updated Jul 23rd, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992776678 NPPES
Colorado MEDICAID 07106081

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