Lifespan Psychiatry of Colorado
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Ridgway, CO
NPI 1295554475 · NPPES record last updated Oct 7, 2024
Key facts
- NPI
- 1295554475
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- LIFESPAN PSYCHIATRY OF COLORADO
- Practice address
- 195 S Lena St
Ridgway, CO 81432-8973 - Phone
- (970) 579-0003
- NPI assigned
- Oct 7, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- LIFESPAN PSYCHIATRY OF COLORADO INC.
Authorized official
- Name
- Carrie Shahbahrami
- Title
- Pmhnp/Owner
- Phone
- (970) 579-0003
Other NPIs on the same Medicare enrollment 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210121000197 | CO | Part B Supplier - Clinic/Group Practice | 0749694495 |
Receives reassigned benefits from 14 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Grand Junction, CO; Delta, CO |
National Provider Directory
- Part of
- Lifespan Psychiatry of Colorado Inc
Locations
195 S Lena St
Ridgway, CO 81432
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
195 S Lena St
Ridgway, CO 81432-8973
Mailing address
2140 N 12TH St
Grand Junction, CO 81501-2916
Other providers in Ridgway, CO
- L. James Kennedy Jr.
- Katharine Kissingford
- James Philip Kornberg
- Caitlin R Lawshe
- Adrianna Lee
- Debra Ann Loberger
- David Malin
- Lawrence Lynch McReynolds
- Mindfulness Based Interventions LLC
- Mindfulness Based Interventions LLC
All providers in Ridgway, CO · Mental Health Clinic/Center (Including Community Mental Health Center) in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.