Active NPI
Melissa A Cole, PSYD
- Clinical Psychologist
- Pueblo, CO
National Provider Identifier
1336604560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0004957
- Practice address
- 1601 Constitution Rd
Pueblo, CO 81001-2132 - Phone
- (719) 562-7288
- NPI assigned
- Feb 1, 2019
- Last updated
- Feb 1, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0004957 | CO | Primary |
Addresses
Primary practice location
1601 Constitution Rd
Pueblo, CO 81001-2132
Mailing address
5315 Aubrey Way
Colorado Springs, CO 80919-3500
Phone (210) 241-1282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004957 | Other | CO | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0004957 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1336604560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5315 AUBREY WAY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809193500",
"telephone_number": "210-241-1282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 CONSTITUTION RD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810012132",
"telephone_number": "719-562-7288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "MELISSA",
"middle_name": "A",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-01",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "0004957",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "0004957",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.