Gayle Ann Civish, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1170 Issued in CO

Practice address

10200 W 44TH Ave
Suite 210-B
Wheat Ridge, CO 80033-2837

Phone

(303) 443-9570

NPI assigned

May 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Sep 15, 2014 through Sep 15, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083829055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 CONEFLOWER CT",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800276012",
            "telephone_number": "303-443-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 W 44TH AVE",
            "address_2": "SUITE 210-B",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332837",
            "telephone_number": "303-443-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVISH",
        "first_name": "GAYLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "1170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Christiansen, DDS
• Erin Jean Christianson
• Laura C Ciancio, O.D.
• Amber Cibrian
• Charles Anthony Ciociola Jr.
• Amber Lee Clark, PHARMD
• Charles Francis Clark, MD
• Forrest Joshua Clark
• Michael Adam Clark
• Kerry Clarke, MD

• Psychologist in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.