Organization Active NPI

Memory Bridging Incorporated

  • Cognitive & Behavioral Psychologist
  • Parker, CO
National Provider Identifier
1386827293
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
803 Issued in CO
Legal business name
MEMORY BRIDGING INCORPORATED
Practice address
16154 Rock Crystal Dr
Parker, CO 80134-3305
Phone
(303) 328-1195
Fax
(303) 557-6240
NPI assigned
Dec 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Authorized official

Name
Susanne E Baber
Title
Director of Administration
Phone
(850) 267-0030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X 803 CO Primary

Addresses

Primary practice location

16154 Rock Crystal Dr
Parker, CO 80134-3305

Mailing address

141 Mack Bayou Loop
Suite 201
Santa Rosa Beach, FL 32459-7194
Phone (850) 267-0030

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1386827293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MACK BAYOU LOOP",
            "address_2": "SUITE 201",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597194",
            "telephone_number": "850-267-0030",
            "fax_number": "850-267-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16154 ROCK CRYSTAL DR",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801343305",
            "telephone_number": "303-328-1195",
            "fax_number": "303-557-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORY BRIDGING INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "BABER",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "850-267-0030"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CO",
            "license": "803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.