Organization Active NPI

Empowered Living PLLC

  • Psychologist
  • Denver, CO
National Provider Identifier
1215633698
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
EMPOWERED LIVING PLLC
Practice address
3401 Quebec St Ste 4300
Denver, CO 80207-2322
Phone
(720) 315-4647
NPI assigned
Feb 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Authorized official

Name
Anahita Lake-Khosravi, PSYDNPI 1922524701
Title
Ceo
Phone
(720) 315-4647

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 10

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X
Developmental Disabilities Clinic/Center 261QD1600X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3401 Quebec St Ste 4300
Denver, CO 80207-2322

Mailing address

3401 Quebec St Ste 4300
Denver, CO 80207-2322
Phone (720) 315-4647

Other identifiers 1

IdentifierTypeStateIssuer
9000210453MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Empowered Living PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3401 Quebec St
Ste 4300
Denver, CO 80207
Phone (720) 315-4647

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1215633698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 QUEBEC ST STE 4300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072322",
            "telephone_number": "720-315-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 QUEBEC ST STE 4300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072322",
            "telephone_number": "720-315-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED LIVING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "LAKE-KHOSRAVI",
        "authorized_official_first_name": "ANAHITA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-315-4647",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000210453",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.

Verify at the official NPI Registry.