Colorado Neuropsychology Services LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

COLORADO NEUROPSYCHOLOGY SERVICES LLC

Practice address

255 Canyon Blvd
Ste. 200
Boulder, CO 80302-4979

Phone

(303) 474-4055

Fax

(720) 638-3699

NPI assigned

Mar 3, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Elise Ginsburg Stevens, PH. D.

Title

Licensed Psychologist - Owner

Phone

(303) 474-4055

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1366802308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 CANYON BLVD",
            "address_2": "STE. 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024979",
            "telephone_number": "303-474-4055",
            "fax_number": "720-638-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 CANYON BLVD",
            "address_2": "STE. 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024979",
            "telephone_number": "303-474-4055",
            "fax_number": "720-638-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO NEUROPSYCHOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "GINSBURG STEVENS",
        "authorized_official_first_name": "ELISE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST - OWNER",
        "authorized_official_telephone_number": "303-474-4055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "659509",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.