Kiersten Michele Eberle Medina, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Practice address

11150 W 102ND Ave
Westminster, CO 80021-6604

Phone

(714) 931-5559

NPI assigned

Aug 3, 2020

Last updated

Jan 17, 2023By the provider in NPPES

Sex

Female

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

Opted out of Medicare

Yes, effective Feb 17, 2026 through Feb 17, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

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

• Colorado Therapy & Assessment Center

  • Clinical Psychologist
  • Westminster, CO
  • NPI 1205478757
  NPD (past)

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1912517202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 W 102ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800216604",
            "telephone_number": "714-931-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 W 102ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800216604",
            "telephone_number": "714-931-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLE MEDINA",
        "first_name": "KIERSTEN",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela M Dyrdal, RN
• Richard Dziallo, PHARMD
• Eagle Counseling Services, Inc.
• Daniel Eaker, MA
• Kathy A Earnst, RN
• Rachael Eccher, MA, LPCC, NCC
• Thomas Brady Echohawk-Thompson
• Stanley J. Echt, DMD
• William McKinley Eckhart, M.D.
• Stacey Eckman, LMT

• Counseling Psychologist in Westminster, CO
• Providers in Westminster, CO by specialty
• Counseling Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.