Psychological Services, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

633 AND 1746 Issued in CO

Legal business name

PSYCHOLOGICAL SERVICES, P.C.

Practice address

613 Walnut St
Boulder, CO 80302-5031

Phone

(303) 443-1223

Fax

(303) 473-9153

NPI assigned

May 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Joan C. Soper, PH.D.

Title

VP

Phone

(303) 443-1223

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1679522817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 WALNUT ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025031",
            "telephone_number": "303-443-1223",
            "fax_number": "303-473-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 WALNUT ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025031",
            "telephone_number": "303-443-1223",
            "fax_number": "303-473-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-06",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "SOPER",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "303-443-1223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "633 AND 1746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04010732",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Prudlo
• Andrew L Pruitt, P.A.
• Melissa Pruitt
• Charlotte Inez Psaila
• Psychological Services Corporation
• Travis Ptomey, DC
• Tara K Puccio, PT
• Susan Puckett, P.A.
• Katrina Puente
• Heather C Pujet, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.