Individual provider Active NPI

David Lloyd Avram, PHD

  • Clinical Psychologist
  • Arvada, CO
National Provider Identifier
1205582277
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0005748 Issued in CO
Practice address
11005 Ralston Rd Ste 100G
Arvada, CO 80004-4551
Phone
(303) 360-6276
Fax
(303) 789-7222
NPI assigned
Feb 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY.0005748 CO
Clinical Psychologist 103TC0700X PSY.0005748 CO Primary

Addresses

Primary practice location

11005 Ralston Rd Ste 100G
Arvada, CO 80004-4551

Mailing address

7495 W 29TH Ave
Wheat Ridge, CO 80033-8002
Phone (303) 761-1977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125003260 CO Practitioner - Clinical Psychologist 5395116545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY.0005748COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Community Provider Network, Inc. CurrentSince Oct 14, 2022 Accepting new patients
Metro Community Provider Network Inc CurrentSince Oct 14, 2022 Accepting new patients
Metro Community Provider Network Inc Current Accepting new patients

Locations

11005 Ralston Rd
Ste 100G
Arvada, CO 80004
Phone (303) 431-0844

2255 S Oneida St
Denver, CO 80224

17866 Cottonwood Dr
Parker, CO 80134
Phone (303) 205-6899

7495 W 29th Ave
Wheat Ridge, CO 80033
Phone (303) 239-9964

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1205582277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7495 W 29TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800338002",
            "telephone_number": "303-761-1977",
            "fax_number": "303-343-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11005 RALSTON RD STE 100G",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044551",
            "telephone_number": "303-360-6276",
            "fax_number": "303-789-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVRAM",
        "first_name": "DAVID",
        "middle_name": "LLOYD",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-28",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0005748",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0005748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.