Active NPI
Beth R Olin, ED.D.
- Psychologist
- Fort Carson, CO
National Provider Identifier
1780965053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1636
- Practice address
- 1650 Cochrane Cir
Fort Carson, CO 80913-4603 - Phone
- (719) 503-7070
- NPI assigned
- Aug 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 1636 | CO | Primary |
Addresses
Primary practice location
1650 Cochrane Cir
Fort Carson, CO 80913-4603
Mailing address
15 Heather Dr
Colorado Springs, CO 80906-3186
Phone (719) 630-3637
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1636 | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314748800000",
"number": "1780965053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 HEATHER DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809063186",
"telephone_number": "719-630-3637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 COCHRANE CIR",
"city": "FORT CARSON",
"state": "CO",
"postal_code": "809134603",
"telephone_number": "719-503-7070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIN",
"first_name": "BETH",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-31",
"last_updated": "2011-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "1636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Carson, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.