Active NPI
Trina Renee Brown, MFTI
- Marriage & Family Therapist
- Boulder, CO
National Provider Identifier
1033540018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT.0001596
- Practice address
- 2825 Marine St Ste 203
Boulder, CO 80303-1027 - Phone
- (720) 605-6605
- NPI assigned
- Dec 2, 2013
- Last updated
- Mar 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 73553 | CA | |
| Marriage & Family Therapist | 106H00000X | MFT.0001596 | CO | Primary |
Addresses
Primary practice location
2825 Marine St Ste 203
Boulder, CO 80303-1027
Mailing address
2825 Marine St Ste 203
Boulder, CO 80303-1027
Phone (720) 605-6605
Other practice location 1
1360 Johnson Blvd
Suite 103
South Lake Tahoe, CA 96150-8220
Phone (530) 573-7962
Other names 1
- Trina Renee Moss
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 73553 | CA | MD | Marriage & Family Therapist |
| MFT.0001596 | CO | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1033540018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 MARINE ST STE 203",
"city": "BOULDER",
"state": "CO",
"postal_code": "803031027",
"telephone_number": "720-605-6605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 MARINE ST STE 203",
"city": "BOULDER",
"state": "CO",
"postal_code": "803031027",
"telephone_number": "720-605-6605"
}
],
"practiceLocations": [
{
"address_1": "1360 Johnson Blvd",
"address_2": "Suite 103",
"address_purpose": "LOCATION",
"city": "South Lake Tahoe",
"state": "CA",
"postal_code": "961508220",
"country_code": "US",
"telephone_number": "530-573-7962",
"fax_number": "530-543-6873",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN",
"first_name": "TRINA",
"middle_name": "RENEE",
"credential": "MFTI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-02",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 73553",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "CO",
"license": "MFT.0001596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TRINA",
"last_name": "MOSS",
"middle_name": "RENEE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.