Bryce Craig Willson, MA, CACIII, LPC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3874 Issued in CO

Practice address

3575 S Washington St
Englewood, CO 80113-3807

Phone

(303) 789-2265

NPI assigned

Oct 4, 2005

Last updated

Apr 18, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• An Intuitive Mind Counseling Consulting & Psychological Service

  • Psychologist
  • Centennial, CO
  • NPI 1043753734
  Medicare reassignment NPD Authorized official
• Poudre Valley Health Care Inc

  dba Poudre Valley Health System

  • General Acute Care Hospital
  • Greeley, CO
  • NPI 1962158857
  NPD
• Poudre Valley Health Care Inc.

  dba Poudre Valley Hospital

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1760492714
  NPD
• Poudre Valley Health Care, Inc

  • Medical Specialty Clinic/Center
  • Fort Collins, CO
  • NPI 1144535444
  NPD

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1518954643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 ROBB ST",
            "address_2": "SUITE 201",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332184",
            "telephone_number": "303-278-7418",
            "fax_number": "303-223-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 S WASHINGTON ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133807",
            "telephone_number": "303-789-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "BRYCE",
        "middle_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "MA, CACIII, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "5782",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "2955",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "3874",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11638726",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillip Williams, PT, DPT
• Rachel Williams, NP-C
• Holly Williamson
• Mindy Gay Willits, RN NP
• Andrea Willmann, COTA/L
• Joel E Wilson, MD
• Kettia Wilson, MSN NC-BC RN
• Laura Wilson, RBT
• Mattea Wilson, BCBA
• Nicole Wilson, PA

• Clinical Psychologist in Englewood, CO
• Providers in Englewood, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.