Organization Name: | GARY L. KAAKE, PSYD, PC |
NPI Number: | 1629163720 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY LEE KAAKE (PRESIDENT) |
Mailing Address: | 8790 W Colfax Ave Suite 250 Lakewood |
State: | CO US |
Postal Code: | 802154092 |
Phone Number: | 3032340827 |
Fax Number: | 3032341771 |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 10/03/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 1212 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |