Individual provider Active NPI

Colleen Ehrnstrom, PHD

  • Cognitive & Behavioral Psychologist
  • Boulder, CO
National Provider Identifier
1720364011
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
2785 Issued in CO
Practice address
3020 Carbon PL Ste 200
Boulder, CO 80301-6164
Phone
(303) 579-3245
NPI assigned
Oct 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 2785 CO Primary

Addresses

Primary practice location

3020 Carbon PL Ste 200
Boulder, CO 80301-6164

Mailing address

3020 Carbon PL Ste 200
Boulder, CO 80301-6164
Phone (303) 579-3245

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
2785COMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1720364011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CARBON PL STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803016164",
            "telephone_number": "303-579-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CARBON PL STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803016164",
            "telephone_number": "303-579-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRNSTROM",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CO",
            "license": "2785",
            "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 Oct 31, 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.