Active NPI
Michele Adrienne Packard, PHD
- Psychologist
- Boulder, CO
National Provider Identifier
1932618782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 879
- Practice address
- 4410 Arapahoe Suite 140
Boulder, CO 80303 - Phone
- (303) 443-3920
- Fax
- (720) 600-0312
- NPI assigned
- Sep 25, 2017
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 879 | CO | Primary |
Addresses
Primary practice location
4410 Arapahoe Suite 140
Boulder, CO 80303
Mailing address
PO Box 862
Boulder, CA 80306
Phone (303) 443-3920
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 |
|---|---|---|---|
| 879 | CO | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506297600000",
"number": "1932618782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 862",
"city": "BOULDER",
"state": "CA",
"postal_code": "80306",
"telephone_number": "303-443-3920",
"fax_number": "720-600-0312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 ARAPAHOE SUITE 140",
"city": "BOULDER",
"state": "CO",
"postal_code": "80303",
"telephone_number": "303-443-3920",
"fax_number": "720-600-0312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACKARD",
"first_name": "MICHELE",
"middle_name": "ADRIENNE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-25",
"last_updated": "2017-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.