Active NPI
Michelle Vienna Flores, MA
- School Psychologist
- Lyons, CO
National Provider Identifier
1477211571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 200125649
- Practice address
- 124 Falcon LN
Lyons, CO 80540-4212 - Phone
- (661) 885-5086
- NPI assigned
- Dec 6, 2021
- Last updated
- Dec 12, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 24386867 | CO | |
| School Psychologist | 103TS0200X | 200125649 | CA | Primary |
Addresses
Primary practice location
124 Falcon LN
Lyons, CO 80540-4212
Mailing address
124 Falcon LN
Lyons, CO 80540-4212
Phone (661) 885-5086
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200125649 | CA | MD | School Psychologist |
| 24386867 | CO | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639267200000",
"number": "1477211571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 FALCON LN",
"city": "LYONS",
"state": "CO",
"postal_code": "805404212",
"telephone_number": "661-885-5086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 FALCON LN",
"city": "LYONS",
"state": "CO",
"postal_code": "805404212",
"telephone_number": "661-885-5086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLORES",
"first_name": "MICHELLE",
"middle_name": "VIENNA",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-06",
"last_updated": "2021-12-12",
"certification_date": "2021-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CO",
"license": "24386867",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "200125649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lyons, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.