Organization · Type 2 NPI

Poudre Valley Medical Group, LLC

Psychiatry Physician · Pueblo, CO

NPI number 1063209534 Active

Practice location

56 Club Manor Dr Ste 100
Pueblo, CO 81008-1685

Call (719) 584-4767 Map

Fax (719) 595-7906

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

Specialties and licenses

Taxonomy	Code	License
Professional Counselor	101YP2500X	None listed
Psychiatry Physician Primary	2084P0800X	None listed

Psychiatry Physician: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic la…

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NPI record

NPI: 1063209534
Entity type: Organization (Type 2)
Issued: Apr 21, 2025
Last updated: Apr 21, 2025
Status: Active
Subpart: Yes of Poudre Valley Medical Group, LLC

Other names

Uchealth Medical Group · doing business as
Uchealth Behavioral Health Clinic - Pueblo · other name

Authorized official

Jana Conroy
Director of Credentialing
(719) 584-4767

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1063209534

Poudre Valley Medical Group, LLC's National Provider Identifier is 1063209534, issued on Apr 21, 2025. The primary taxonomy on file is Psychiatry Physician (2084P0800X), and the practice location is in Pueblo, CO. The record was last updated on Apr 21, 2025.