Organization Active NPI

Eric Siiteri PHD LLC

  • Clinical Psychologist
  • Casper, WY
National Provider Identifier
1932178696
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ERIC SIITERI PHD LLC
Practice address
111 S Jefferson St
Casper, WY 82601-2665
Phone
(970) 495-0707
Fax
(970) 495-6885
NPI assigned
Mar 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Authorized official

Name
Mrs. Chris L Siiteri
Title
Business Manager
Phone
(970) 495-0707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

111 S Jefferson St
Casper, WY 82601-2665

Mailing address

PO Box 955
Fort Collins, CO 80522-0955
Phone (970) 495-0707

Other identifiers 1

IdentifierTypeStateIssuer
118233101MedicaidWY

National Provider Directory

National Provider Directory

Locations

111 S Jefferson St
Casper, WY 82601
Phone (970) 495-0707

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1932178696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805220955",
            "telephone_number": "970-495-0707",
            "fax_number": "970-495-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S JEFFERSON ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012665",
            "telephone_number": "970-495-0707",
            "fax_number": "970-495-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC SIITERI PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "SIITERI",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "970-495-0707",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118233101",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.