Active NPI
Children's Trauma Center, LLC
- Community/Behavioral Health Agency
- Fairplay, CO
National Provider Identifier
1215759774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- CHILDREN'S TRAUMA CENTER, LLC
- Practice address
- 295 5TH Street
Suite 8
Fairplay, CO 80440-5016 - Phone
- (720) 262-1279
- NPI assigned
- Oct 28, 2024
- Last updated
- May 8, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karen Renee Blackwell, LCSW
- Title
- Executive Director
- Phone
- (720) 262-1279
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
295 5TH Street
Suite 8
Fairplay, CO 80440-5016
Mailing address
26719 Pleasant Park Rd
Unit 120
Conifer, CO 80433
Phone (720) 262-1279
National Provider Directory
National Provider Directory- Tax ID family
- Children's Trauma Center LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Conifer, CO
- NPI 1083435051
-
- Clinical Social Worker
- Conifer, CO
- NPI 1376272377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730073600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746662400000",
"number": "1215759774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26719 PLEASANT PARK RD",
"address_2": "UNIT 120",
"city": "CONIFER",
"state": "CO",
"postal_code": "80433",
"telephone_number": "720-262-1279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 5TH STREET",
"address_2": "SUITE 8",
"city": "FAIRPLAY",
"state": "CO",
"postal_code": "804405016",
"telephone_number": "720-262-1279"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILDREN'S TRAUMA CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-28",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A",
"authorized_official_last_name": "BLACKWELL",
"authorized_official_first_name": "KAREN",
"authorized_official_middle_name": "RENEE",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "720-262-1279",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairplay, CO
- Brett Berns, LMT, CPT
- Blue Skies Behavioral Group LLC
- Marta Sue Butler-Bearzi, R.D.H.
- James E Caldwell, DDS
- Patricia L Chandler, PHD, MA, LPC, MAC
- Conifer Counseling and Therapy Services, Inc
- Conifer Counseling and Therapy Services, Inc (Park County Counseling)
- Connect Movement Center LLC (Connect Movement Center)
- County of Park Dba Park County Public Health
- Shirlene Davis, LMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.