Edward Phillip Mockus, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0004518 Issued in CO

Practice address

5277 Manhattan Cir Ste 102
Boulder, CO 80303-8200

Phone

(720) 526-0579

NPI assigned

Jul 15, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edward Mockus PHD PLLC

  • Psychologist
  • Boulder, CO
  • NPI 1871188458
  NPD Authorized official

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1902213655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5277 MANHATTAN CIR STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803038200",
            "telephone_number": "720-526-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5277 MANHATTAN CIR STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803038200",
            "telephone_number": "720-526-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCKUS",
        "first_name": "EDWARD",
        "middle_name": "PHILLIP",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "0004518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mergen Alana Mittleider
• Aqui Mizrahi, L.AC
• Tal Liza Mizrahi, LPCC
• Mmclinic, LLC
• William Leslie Moats, LPC
• Naomi Moddel, LCSW
• Janine Marie Moderski, MA, LPC
• Kelsie Modlich
• Rachael Moe, MA
• Stephen Moe, MD

• Psychologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.