Active NPI
Karrie Ann Lyons-Sjostrom, PSY.D.
- Clinical Psychologist
- Evergreen, CO
National Provider Identifier
1285877100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3302
- Practice address
- 29029 Upper Bear Creek Rd Ste 301
Evergreen, CO 80439-7738 - Phone
- (720) 254-4093
- NPI assigned
- Apr 7, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3302 | CO | Primary |
Addresses
Primary practice location
29029 Upper Bear Creek Rd Ste 301
Evergreen, CO 80439-7738
Mailing address
PO Box 131
Evergreen, CO 80437-0131
Phone (720) 254-4093
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 22, 2016 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3302 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239062400000",
"number": "1285877100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 131",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804370131",
"telephone_number": "720-254-4093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29029 UPPER BEAR CREEK RD STE 301",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804397738",
"telephone_number": "720-254-4093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS-SJOSTROM",
"first_name": "KARRIE",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-07",
"last_updated": "2009-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "3302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.