Active NPI
Marcia L Braden, PHD
- Clinical Child & Adolescent Psychologist
- Colorado Springs, CO
National Provider Identifier
1891063582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 1894
- Practice address
- 214 E Dale St
#110
Colorado Springs, CO 80903-4729 - Phone
- (719) 633-3773
- Fax
- (719) 633-9705
- NPI assigned
- Dec 8, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1894 | CO | Primary |
Addresses
Primary practice location
214 E Dale St
#110
Colorado Springs, CO 80903-4729
Mailing address
214 E Dale St
#110
Colorado Springs, CO 80903-4729
Phone (719) 633-3773
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609913011 | Other | CO | NPI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1894 | CO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1891063582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 E DALE ST",
"address_2": "#110",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809034729",
"telephone_number": "719-633-3773",
"fax_number": "719-633-9705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 E DALE ST",
"address_2": "#110",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809034729",
"telephone_number": "719-633-3773",
"fax_number": "719-633-9705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADEN",
"first_name": "MARCIA",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CO",
"license": "1894",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1609913011",
"state": "CO"
}
],
"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 Dec 8, 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.