Individual provider Active NPI

Brian Mark Seavey, PSY.D.

  • Clinical Psychologist
  • Ft Carson, CO
National Provider Identifier
1770651002
Registry record updated Jul 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3084 Issued in CO
Practice address
1650 Cochrane Cir
Dept of Behavioral Health
Ft Carson, CO 80913-4604
Phone
(253) 282-3860
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3084 CO Primary

Addresses

Primary practice location

1650 Cochrane Cir
Dept of Behavioral Health
Ft Carson, CO 80913-4604

Mailing address

10 Boulder Crescent St Ste 204B
Colorado Springs, CO 80903-3355
Phone (719) 233-0138

Other practice location 1

10 Boulder Crescent St Ste 204B
Colorado Springs, CO 80903-3355
Phone (719) 233-0138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070626000406 CO Practitioner - Clinical Psychologist 6103922000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3084COMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721520000000",
    "number": "1770651002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BOULDER CRESCENT ST STE 204B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033355",
            "telephone_number": "719-233-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "address_2": "DEPT OF BEHAVIORAL HEALTH",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "253-282-3860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Boulder Crescent St Ste 204B",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809033355",
            "country_code": "US",
            "telephone_number": "719-233-0138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEAVEY",
        "first_name": "BRIAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2024-07-21",
        "certification_date": "2024-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Carson, CO

Sources for this page

Verify at the official NPI Registry.