Active NPI
David M Nielsen, PH D
- Psychologist
- Colville, WA
National Provider Identifier
1669544771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY00002019
- Practice address
- 165 E Hawthorne Ave
Colville, WA 99114-2629 - Phone
- (509) 684-4597
- NPI assigned
- Nov 14, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | PY00002019 | WA | Primary |
Addresses
Primary practice location
165 E Hawthorne Ave
Colville, WA 99114-2629
Mailing address
620 E 10TH Ave
Colville, WA 99114-9410
Phone (509) 685-1965
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00002019 | WA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stevens County | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Northeast Washington Alliance Behavioral Health
- Mental Illness Community Based Residential Treatment Facility
- Colville, WA
- NPI 1922517192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669544771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 E 10TH AVE",
"city": "COLVILLE",
"state": "WA",
"postal_code": "991149410",
"telephone_number": "509-685-1965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 E HAWTHORNE AVE",
"city": "COLVILLE",
"state": "WA",
"postal_code": "991142629",
"telephone_number": "509-684-4597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSEN",
"first_name": "DAVID",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PH D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00002019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colville, WA
- New Health Programs Association (Colville Community Health Center Pharmacy)
- Trinell P. Newby
- Victoria M Nichols
- Beck Nickel, N.D.
- Cynthia K Nielsen
- Joshua Michael Norris, SUDP-T
- Northeast Tri County Health District
- Northeast Tri County Health District
- Northeast Tri County Health District
- Northeast Washington Alliance Counseling
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.