Organization Active NPI

An Intuitive Mind Counseling Consulting & Psychological Service

  • Psychologist
  • Centennial, CO
National Provider Identifier
1043753734
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3874 Issued in CO
Legal business name
AN INTUITIVE MIND COUNSELING CONSULTING & PSYCHOLOGICAL SERVICE
Practice address
12835 East Arapahoe Rd
Tower II, Suite 440
Centennial, CO 80112-4037
Phone
(720) 984-0244
NPI assigned
Nov 29, 2016
Last updated
Apr 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Authorized official

Name
Bryce Craig WillsonNPI 1518954643
Title
Psychologist/Owner
Phone
(720) 984-0244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3874 CO Primary

Addresses

Primary practice location

12835 East Arapahoe Rd
Tower II, Suite 440
Centennial, CO 80112-4037

Mailing address

12835 East Arapahoe Rd
Tower II, Suite 440
Centennial, CO 80112-4037
Phone (720) 984-0244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180509000456 CO Part B Supplier - Clinic/Group Practice 3173887635 Receives reassigned benefits from 1 practitioner
Practice locations: Centennial, CO

National Provider Directory

National Provider Directory

Locations

6402 S Troy Cir
Ste 340
Centennial, CO 80111
Phone (303) 214-5299

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523232000000",
    "number": "1043753734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12835 EAST ARAPAHOE RD",
            "address_2": "TOWER II, SUITE 440",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801124037",
            "telephone_number": "720-984-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12835 EAST ARAPAHOE RD",
            "address_2": "TOWER II, SUITE 440",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801124037",
            "telephone_number": "720-984-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AN INTUITIVE MIND COUNSELING CONSULTING & PSYCHOLOGICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-29",
        "last_updated": "2018-04-09",
        "status": "A",
        "authorized_official_last_name": "WILLSON",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "720-984-0244"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "3874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.