Individual provider Active NPI

Samantha Lynn Awalt, PHD

  • Psychologist
  • Lakewood, CO
National Provider Identifier
1215734389
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSYC.00015065 Issued in CO
Practice address
575 Union Blvd Ste 210
Lakewood, CO 80228-1242
Phone
(720) 984-1219
NPI assigned
Feb 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSYC.00015065 CO Primary

Addresses

Primary practice location

575 Union Blvd Ste 210
Lakewood, CO 80228-1242

Mailing address

575 Union Blvd Ste 210
Lakewood, CO 80228-1242
Phone (720) 984-1219

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSYC.00015065COMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1215734389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 UNION BLVD STE 210",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281242",
            "telephone_number": "720-984-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 UNION BLVD STE 210",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281242",
            "telephone_number": "720-984-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWALT",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSYC.00015065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.