Active NPI
Grounded Mind Psychology PLLC
- Psychologist
- Broomfield, CO
National Provider Identifier
1073478137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- 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, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jamal Waire, PSYD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryPractitioners & 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.
-
- Cognitive & Behavioral Psychologist
- Boulder, CO
- NPI 1295451417
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.