Individual provider Active NPI

James K Childerston, PH.D.

  • Clinical Psychologist
  • Loveland, CO
National Provider Identifier
1205833449
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY0005723 Issued in CO
Practice address
1910 Sunshine Peak Dr
Loveland, CO 80538-7217
Phone
(301) 991-1018
NPI assigned
Jul 1, 2005
Last updated
May 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY0005723 CO
Clinical Psychologist 103TC0700X PSY0005723 CO Primary
Counseling Psychologist 103TC1900X PSY0005723 CO
Clinical Child & Adolescent Psychologist 103TC2200X PSY0005723 CO

Addresses

Primary practice location

1910 Sunshine Peak Dr
Loveland, CO 80538-7217

Mailing address

1910 Sunshine Peak Dr
Loveland, CO 80538-7217
Phone (301) 991-1018

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
I20240308000759 CO Practitioner - Clinical Psychologist 8426237553 Practice locations: Loveland, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1910 Sunshine Peak Dr
Loveland, CO 80538-7217

2641 Taft Ave
Suite 203
Loveland, CO 80538-3121
Phone (301) 991-1018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY0005723COMDClinical Child & Adolescent Psychologist
02307MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Counseling, LLC PastSince Sep 1, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1205833449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SUNSHINE PEAK DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805387217",
            "telephone_number": "301-991-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SUNSHINE PEAK DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805387217",
            "telephone_number": "301-991-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERSTON",
        "first_name": "JAMES",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY0005723",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY0005723",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CO",
            "license": "PSY0005723",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CO",
            "license": "PSY0005723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.