Provider Demographics
NPI:1194938837
Name:AUDIOLOGICAL CONSULTANTS, INC
Entity type:Organization
Organization Name:AUDIOLOGICAL CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:NORTHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSM
Authorized Official - Phone:303-761-7600
Mailing Address - Street 1:230 S NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4234
Mailing Address - Country:US
Mailing Address - Phone:970-252-0444
Mailing Address - Fax:970-252-7377
Practice Address - Street 1:230 S NEVADA AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4234
Practice Address - Country:US
Practice Address - Phone:970-252-0444
Practice Address - Fax:970-252-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04455093Medicaid
CO443778Medicare ID - Type Unspecified
COP40993Medicare UPIN