Individual provider Active NPI

Mimi Bradley McFaul, PSY.D.

  • Clinical Psychologist
  • Centennial, CO
National Provider Identifier
1801082250
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3063 Issued in CO
Practice address
7030 S Yosemite St
Centennial, CO 80112-2026
Phone
(720) 252-4750
NPI assigned
Sep 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3063 CO Primary
Health Psychologist 103TH0004X 3063 CO

Addresses

Primary practice location

7030 S Yosemite St
Centennial, CO 80112-2026

Mailing address

5392 Golf Course Dr
Morrison, CO 80465-2148
Phone (720) 252-4750

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1801082250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5392 GOLF COURSE DR",
            "city": "MORRISON",
            "state": "CO",
            "postal_code": "804652148",
            "telephone_number": "720-252-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 S YOSEMITE ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122026",
            "telephone_number": "720-252-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFAUL",
        "first_name": "MIMI",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3063",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "CO",
            "license": "3063",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.