Organization Active NPI

Grounded Mind Psychology PLLC

  • Psychologist
  • Broomfield, CO
National Provider Identifier
1073478137
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
GROUNDED MIND PSYCHOLOGY PLLC
Practice address
11994 Ridge Pkwy
Broomfield, CO 80021-5155
Phone
(702) 464-7515
NPI assigned
Dec 22, 2025
Last updated
Dec 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Authorized official

Name
Jamal Waire, PSYDNPI 1295451417
Title
Owner
Phone
(718) 915-1426

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

11994 Ridge Pkwy
Broomfield, CO 80021-5155

Mailing address

4845 Pearl East Circle Ste 118
PMB 57630
Boulder, CO 80301

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1073478137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 PEARL EAST CIRCLE STE 118",
            "address_2": "PMB 57630",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11994 RIDGE PKWY",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800215155",
            "telephone_number": "702-464-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUNDED MIND PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-21",
        "status": "A",
        "authorized_official_last_name": "WAIRE",
        "authorized_official_first_name": "JAMAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-915-1426",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.