Individual provider Active NPI

Patricia Guffey Carruth, PSYD, MSW

  • Clinical Psychologist
  • Boulder, CO
National Provider Identifier
1891894390
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2447 Issued in CO
Practice address
4135 Autumn Court
Boulder, CO 80304
Phone
(303) 588-1788
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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 2447 CO Primary

Addresses

Primary practice location

4135 Autumn Court
Boulder, CO 80304

Mailing address

3393 Iris Avenue, Suite 208
Boulder, CO 80301
Phone (303) 415-2725

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
I20150917000735 CO Practitioner - Clinical Psychologist 0749597136 Practice locations: Boulder, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3393 Iris Ave
Suite 208
Boulder, CO 80301-1956
Phone (303) 415-2725

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1891894390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3393 IRIS AVENUE, SUITE 208",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80301",
            "telephone_number": "303-415-2725",
            "fax_number": "720-302-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 AUTUMN COURT",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80304",
            "telephone_number": "303-588-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUTH",
        "first_name": "PATRICIA",
        "middle_name": "GUFFEY",
        "name_prefix": "Dr.",
        "credential": "PSYD, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.