Individual provider Active NPI

Trina Renee Brown, MFTI

  • Marriage & Family Therapist
  • Boulder, CO
National Provider Identifier
1033540018
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT.0001596 Issued in CO
Practice address
2825 Marine St Ste 203
Boulder, CO 80303-1027
Phone
(720) 605-6605
NPI assigned
Dec 2, 2013
Last updated
Mar 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF 73553 CA
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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 Former name

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

LicenseStateTypeSpecialty
IMF 73553CAMDMarriage & Family Therapist
MFT.0001596COMDMarriage & 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.

Verify at the official NPI Registry.