Active NPI
William Douglas Frea, PH.D.
- Behavior Analyst
- Boulder, CO
National Provider Identifier
1275804304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-07-3520
- Practice address
- 6672 Gunpark Drive
Suite 100
Boulder, CO 80301 - Phone
- (303) 530-4972
- NPI assigned
- Jan 20, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-07-3520 | Primary | |
| Clinical Psychologist | 103TC0700X | 3409 | CO |
Addresses
Primary practice location
6672 Gunpark Drive
Suite 100
Boulder, CO 80301
Mailing address
6672 Gunpark Drive
Suite 100
Boulder, CO 80301
Phone (303) 530-4972
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3409 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412726400000",
"number": "1275804304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6672 GUNPARK DRIVE",
"address_2": "SUITE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "80301",
"telephone_number": "303-530-4972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6672 GUNPARK DRIVE",
"address_2": "SUITE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "80301",
"telephone_number": "303-530-4972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREA",
"first_name": "WILLIAM",
"middle_name": "DOUGLAS",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-20",
"last_updated": "2014-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-07-3520",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "3409",
"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 Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.