NPIMap

Organization Active NPI

Family Peace of Mind, LLC

  • Psychologist
  • Aurora, CO
National Provider Identifier
1215298096
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3619 Issued in CO
Legal business name
FAMILY PEACE OF MIND, LLC
Practice address
2101 S Blackhawk St Ste 240
Aurora, CO 80014-1475
Phone
(720) 316-5840
Fax
(720) 362-2435
NPI assigned
Jun 7, 2012
Last updated
Apr 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Authorized official

Name
Dr. Irene G Ellis, PSYDNPI 1619138070
Title
Owner
Phone
(303) 883-1082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3619 CO Primary

Addresses

Primary practice location

2101 S Blackhawk St Ste 240
Aurora, CO 80014-1475

Mailing address

2101 S Blackhawk St Ste 240
Aurora, CO 80014-1475
Phone (720) 316-5840

Other identifiers 1

IdentifierTypeStateIssuer
61452769MedicaidCO

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": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1215298096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S BLACKHAWK ST STE 240",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141475",
            "telephone_number": "720-316-5840",
            "fax_number": "720-362-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S BLACKHAWK ST STE 240",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141475",
            "telephone_number": "720-316-5840",
            "fax_number": "720-362-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PEACE OF MIND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-883-1082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "3619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61452769",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.