Buck Jack, Llc Dba The Shandy Clinic

Psychology

1325 S Prairie Ave, Pueblo
    Colorado, 81005-2326

 719-597-0822    Maps & Directions
Buck Jack, Llc Dba The Shandy Clinic is a Psychology Clinic in Pueblo, Colorado. It is located at 1325 S Prairie Ave, Pueblo, CO and its contact number is 719-597-0822. The authorized person for Buck Jack, Llc Dba The Shandy Clinic is Tanner Denn who is Credentialing Specialist of the clinic and his/her contact number is 719-428-1840.
Buck Jack, Llc Dba The Shandy Clinic Clinic is specialized in psychological testing and evaluating or assessing patient's personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning. Accordingly, psychologists performs counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy. Psychologists can diagnose and treat mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability by psycheducational evaluation, therapy, remediation, and consultation.
Complete Clinic Profile:
Buck Jack, Llc Dba The Shandy Clinic Clinic speciality, address, contact phone number and fax are as below. Patients can call on the below given phone number for appointments.
Name: Buck Jack, Llc Dba The Shandy Clinic
Specialization: Psychology
Clinic Address:1325 S Prairie Ave, Pueblo,
Colorado, 81005-2326
Phone:719-597-0822
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name: Tanner Denn
Position: Credentialing Specialist
Contact Number: 719-428-1840
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Buck Jack, Llc Dba The Shandy Clinic clinic are as mentioned below.
NPI Number: 1891443370
NPI Enumeration Date: 14 Mar, 2022
NPI Last Update On: 28 Feb, 2024
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Buck Jack, Llc Dba The Shandy Clinic are as mentioned below.
SpecializationLicense NumberStateStatus
Behavioral Analyst Primary
Psychologist Secondary
Behavior Technician Secondary
Physical Therapist Secondary
Occupational Therapist Secondary
Speech-language Pathologist Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
9000203726MedicaidColorado
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: Buck Jack, Llc Dba The Shandy Clinic
2233 Academy Pl Ste 200,
Colorado Springs, Colorado
Zip: 80909-1666
Phone Number: 719-597-0822
Patients can reach Buck Jack, Llc Dba The Shandy Clinic at 1325 S Prairie Ave, Pueblo, Colorado or can call to book an appointment on 719-597-0822.
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 April, 2025.

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