Marek C Dvorak, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY0004303 Issued in CO

Practice address

6610 Gunpark Dr
Suite 101B
Boulder, CO 80301-3460

Phone

(720) 636-4409

NPI assigned

Oct 26, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1114203700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6610 GUNPARK DR",
            "address_2": "SUITE 101B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013460",
            "telephone_number": "720-636-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6610 GUNPARK DR",
            "address_2": "SUITE 101B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013460",
            "telephone_number": "720-636-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORAK",
        "first_name": "MAREK",
        "middle_name": "C",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY0004303",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27642",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Joann Durtschi, LMT
• Ann-Nicole Duryea, D.C.
• Melissa Dutchak, PHARMD, RPH
• Dillon Duval, PA
• Rene Michelle Duvent White, MA, LPC, CAC III
• Kathleen G Dworak, NP-C
• Katherine Marie Dyer, LPCC
• Caitlin Dygulski
• Dynamic Athlete PLLC
• Suzanne Dysart

• Clinical Psychologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.