Cosyleon, Prudencio
Cosyleon, Prudencio is an sole proprietor health care provider with primary practice located at 417 W 13Th St , Pueblo CO 81003-2703. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Cosyleon, Prudencio can be contacted via phone (719) 544-0877.Contact Information
Primary practice address
417 W 13Th St
Pueblo CO 81003-2703
Phone: (719) 544-0877
Fax: (719) 544-2033
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 991432 | Colorado |
Profile Details
| NPI number | 1083775498 |
|---|---|
| LBN Legal business name | Cosyleon, Prudencio |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Mar 14th, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083775498 | NPPES |
| Colorado | Other | 350465YLQP | MEDICARE |
| Colorado | MEDICAID | 02259800 | MEDICARE |
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