Active NPI
Lyndsy Chavarria
- Counselor
- Boulder, CO
National Provider Identifier
1124411798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1942 Broadway Ste 314C
Boulder, CO 80302-5233 - Phone
- (720) 772-1904
- NPI assigned
- Mar 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0204920 | CO | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1942 Broadway Ste 314C
Boulder, CO 80302-5233
Mailing address
1942 Broadway Ste 314C
Boulder, CO 80302-5233
Phone (720) 772-1904
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0204920 | CO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710979200000",
"number": "1124411798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1942 BROADWAY STE 314C",
"city": "BOULDER",
"state": "CO",
"postal_code": "803025233",
"telephone_number": "720-772-1904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1942 BROADWAY STE 314C",
"city": "BOULDER",
"state": "CO",
"postal_code": "803025233",
"telephone_number": "720-772-1904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVARRIA",
"first_name": "LYNDSY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-06",
"last_updated": "2024-03-21",
"certification_date": "2024-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "0204920",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"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 Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.