Provider Demographics
NPI:1902964547
Name:DEVELOPMENTAL DISABILITY CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:DEVELOPMENTAL DISABILITY CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:SPRAGG
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:303-830-7345
Mailing Address - Street 1:1120 LINCOLN ST
Mailing Address - Street 2:STE. 702
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2136
Mailing Address - Country:US
Mailing Address - Phone:303-830-7345
Mailing Address - Fax:303-831-0559
Practice Address - Street 1:1120 LINCOLN ST
Practice Address - Street 2:STE. 702
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2136
Practice Address - Country:US
Practice Address - Phone:303-830-7345
Practice Address - Fax:303-831-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103T00000X
CO1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COUR 19323OtherDIV VOC REHAB
CO04010575Medicaid
COA1606Medicare ID - Type Unspecified