Individual provider Active NPI

Mikaela Therise Woodward

  • School Psychologist
  • Erie, CO
National Provider Identifier
1043001076
Registry record updated May 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
168 Yellowfield Way
Erie, CO 80516-6817
Phone
(720) 969-8680
NPI assigned
May 17, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X CO Primary

Addresses

Primary practice location

168 Yellowfield Way
Erie, CO 80516-6817

Mailing address

168 Yellowfield Way
Erie, CO 80516-6817
Phone (720) 969-8680

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747440000000",
    "number": "1043001076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 YELLOWFIELD WAY",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805166817",
            "telephone_number": "720-969-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 YELLOWFIELD WAY",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805166817",
            "telephone_number": "720-969-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "MIKAELA",
        "middle_name": "THERISE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-17",
        "last_updated": "2025-05-17",
        "certification_date": "2025-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2025; 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.