Brain Space LLC
NPI 1093530479ActiveOrganization· Psychologist, Clinical· Denver, CO
Psychologist, Clinical in Denver, Colorado, registered in NPPES in November 2024. The authorized official on file is Jennifer Medina, PHD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1093530479 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 20, 2024 |
| Last updated in NPPES | Nov 20, 2024 |
| Certified by provider | Nov 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CO) |
|---|
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