Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Buck Jack LLC

Organization Psychologist · NPI 1558975029

Buck Jack LLC is a Psychologist in Fountain, Colorado. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

901 N Santa Fe Ave
Fountain, CO 80817-1738
Phone: (719) 822-0550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X

Record details

NPI number1558975029
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Colt — President · (713) 410-6889
Other names The Shandy Clinic
NPI enumeratedSeptember 2, 2020
Last updated in NPPESSeptember 2, 2020
Certification dateAugust 28, 2020
Mailing address685 Citadel Dr E Ste 580, Colorado Springs, CO 80909-5381

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