Individual provider Active NPI

Eliza May Marie Weitbrecht, PHD

  • Clinical Psychologist
  • Colorado Springs, CO
National Provider Identifier
1881159986
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
30715 Issued in CA
Practice address
3230 E Woodmen Rd Ste 110
Colorado Springs, CO 80920-8502
Phone
(765) 437-9849
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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 30715 CA Primary

Addresses

Primary practice location

3230 E Woodmen Rd Ste 110
Colorado Springs, CO 80920-8502

Mailing address

642 Johanne PL Apt a
Colorado Springs, CO 80906-6457
Phone (765) 437-9849

Other practice location 1

3595 E Fountain Blvd Ste 130
Colorado Springs, CO 80910-1734
Phone (765) 437-9849

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
30715CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1881159986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 JOHANNE PL APT A",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809066457",
            "telephone_number": "765-437-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 E WOODMEN RD STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809208502",
            "telephone_number": "765-437-9849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3595 E Fountain Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809101734",
            "country_code": "US",
            "telephone_number": "765-437-9849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEITBRECHT",
        "first_name": "ELIZA",
        "middle_name": "MAY MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.