Organization Active NPI

Marten Psychotherapy Associates, P.C.

  • Clinical Psychologist
  • Colorado Springs, CO
National Provider Identifier
1447408091
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1395 Issued in CO
Legal business name
MARTEN PSYCHOTHERAPY ASSOCIATES, P.C.
Practice address
4465 Northpark Dr
Suite 300
Colorado Springs, CO 80907-4225
Phone
(719) 471-3125
Fax
(719) 488-1733
NPI assigned
Sep 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Authorized official

Name
Dr. Brad A Marten, PSY.D.NPI 1558425397
Title
President
Phone
(719) 471-3125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 1395 CO Primary

Addresses

Primary practice location

4465 Northpark Dr
Suite 300
Colorado Springs, CO 80907-4225

Mailing address

4465 Northpark Dr
Suite 300
Colorado Springs, CO 80907-4225
Phone (719) 471-3125

Other identifiers 1

IdentifierTypeStateIssuer
07013956MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081017000471 CO Part B Supplier - Clinic/Group Practice 7810065356 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

4465 Northpark Dr
Ste 300
Colorado Springs, CO 80907
Phone (719) 471-3125

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1447408091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 NORTHPARK DR",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074225",
            "telephone_number": "719-471-3125",
            "fax_number": "719-488-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 NORTHPARK DR",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074225",
            "telephone_number": "719-471-3125",
            "fax_number": "719-488-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTEN PSYCHOTHERAPY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "MARTEN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-471-3125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "1395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07013956",
            "state": "CO"
        }
    ],
    "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 Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.