NPIMap

Organization Active NPI

Lillian M. Moeller, PH.D., P.C.

  • Clinical Neuropsychologist
  • Colorado Springs, CO
National Provider Identifier
1396996484
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1558 Issued in CO
Legal business name
LILLIAN M. MOELLER, PH.D., P.C.
Practice address
10 Boulder Crescent St Ste 101B
Colorado Springs, CO 80903-3344
Phone
(719) 442-6955
Fax
(719) 442-6947
NPI assigned
Oct 7, 2008
Last updated
Dec 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Lillian M. Moeller, PH.D.NPI 1215096904
Title
Owner
Phone
(719) 442-6955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 1558 CO Primary

Addresses

Primary practice location

10 Boulder Crescent St Ste 101B
Colorado Springs, CO 80903-3344

Mailing address

10 Boulder Crescent St Ste 101B
Colorado Springs, CO 80903-3344
Phone (719) 442-6955

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1396996484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BOULDER CRESCENT ST STE 101B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033344",
            "telephone_number": "719-442-6955",
            "fax_number": "719-442-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BOULDER CRESCENT ST STE 101B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033344",
            "telephone_number": "719-442-6955",
            "fax_number": "719-442-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLIAN M. MOELLER, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "MOELLER",
        "authorized_official_first_name": "LILLIAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-442-6955",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "1558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.