NPIMap

Organization Active NPI

Marcia L Braden PHD PC

  • Clinical Child & Adolescent Psychologist
  • Colorado Springs, CO
National Provider Identifier
1609913011
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
1894 Issued in CO
Legal business name
MARCIA L BRADEN PHD PC
Practice address
100 E St Vrain Street
Suite 200
Colorado Springs, CO 80903
Phone
(719) 633-3773
Fax
(719) 633-9705
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Marcia L Braden, PHDNPI 1891063582
Title
President
Phone
(719) 633-3773

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 Child & Adolescent PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC2200X 1894 CO Primary

Addresses

Primary practice location

100 E St Vrain Street
Suite 200
Colorado Springs, CO 80903

Mailing address

100 E St Vrain Street
Suite 200
Colorado Springs, CO 80903
Phone (719) 633-3773

National Provider Directory

National Provider Directory

Locations

100 E Saint Vrain St
Ste 200
Colorado Springs, CO 80903
Phone (719) 633-3773

Practitioners & affiliated clinicians

Practitioners 2

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": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609913011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E ST VRAIN STREET",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80903",
            "telephone_number": "719-633-3773",
            "fax_number": "719-633-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E ST VRAIN STREET",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80903",
            "telephone_number": "719-633-3773",
            "fax_number": "719-633-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIA L BRADEN PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADEN",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-633-3773",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CO",
            "license": "1894",
            "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 Aug 22, 2020; 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.