Individual provider Active NPI

Marina Dorian, PHD

  • Psychologist
  • Boulder, CO
National Provider Identifier
1689310716
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
NLC.0110924 Issued in CO
Practice address
2503 Walnut St Ste 210
Boulder, CO 80302-5745
Phone
(303) 872-4077
NPI assigned
May 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NLC.0110924 CO Primary

Addresses

Primary practice location

2503 Walnut St Ste 210
Boulder, CO 80302-5745

Mailing address

1563 Evergreen St
San Diego, CA 92106-2253
Phone (858) 344-8105

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://insightpsychotherapy.theranest.com Direct

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
NLC.0110924COMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1689310716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 EVERGREEN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921062253",
            "telephone_number": "858-344-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 WALNUT ST STE 210",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025745",
            "telephone_number": "303-872-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORIAN",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "NLC.0110924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://insightpsychotherapy.theranest.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2503 Walnut St Ste 210",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803025745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 May 11, 2022; 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.