Provider Demographics
NPI:1174610158
Name:BUCKINGHAM PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:BUCKINGHAM PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN-ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-750-7411
Mailing Address - Street 1:15101 E ILIFF AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4548
Mailing Address - Country:US
Mailing Address - Phone:303-750-7411
Mailing Address - Fax:303-750-5309
Practice Address - Street 1:15101 E ILIFF AVE STE 220
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4548
Practice Address - Country:US
Practice Address - Phone:303-750-7411
Practice Address - Fax:303-750-5309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1345101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07101348Medicaid
CO841533427Medicare UPIN
COC542738Medicare ID - Type Unspecified