Active NPI
Michal Fire
- Clinical Psychologist
- Boulder, CO
National Provider Identifier
1083955975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3735
- Practice address
- 1033 Kalmia Ave
Boulder, CO 80304-1743 - Phone
- (415) 508-7042
- NPI assigned
- Mar 3, 2013
- Last updated
- Mar 3, 2013
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3735 | CO | Primary |
| Clinical Psychologist | 103TC0700X | 24766 | CA |
Addresses
Primary practice location
1033 Kalmia Ave
Boulder, CO 80304-1743
Mailing address
7497A N Foothills Hwy
Boulder, CO 80302-9359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 5, 2025 through May 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24766 | CA | MD | Clinical Psychologist |
| 3735 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362268800000",
"number": "1083955975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7497A N FOOTHILLS HWY",
"city": "BOULDER",
"state": "CO",
"postal_code": "803029359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 KALMIA AVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803041743",
"telephone_number": "415-508-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIRE",
"first_name": "MICHAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-03",
"last_updated": "2013-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "3735",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "24766",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.