Active NPI
Beth Ann Lonergan, PSY.D.
- Psychologist
- Boulder, CO
National Provider Identifier
1528120284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2503
- Practice address
- 1333 Iris Ave
Boulder, CO 80304-2226 - Phone
- (303) 413-6220
- NPI assigned
- Dec 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2503 | CO | Primary |
Addresses
Primary practice location
1333 Iris Ave
Boulder, CO 80304-2226
Mailing address
115 Salina St
Lafayette, CO 80026-3138
Phone (303) 413-6220
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2503 | CO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528120284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 SALINA ST",
"city": "LAFAYETTE",
"state": "CO",
"postal_code": "800263138",
"telephone_number": "303-413-6220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1333 IRIS AVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803042226",
"telephone_number": "303-413-6220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONERGAN",
"first_name": "BETH",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "2503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.