Individual provider Active NPI

Teresa Dawn Black, LMFT

  • Marriage & Family Therapist
  • Grand Junction, CO
National Provider Identifier
1407368889
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT.0002440 Issued in CO
Practice address
300 Main St Ste 103
Grand Junction, CO 81501-2404
Phone
(970) 299-3307
NPI assigned
Oct 25, 2017
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFT.0002440 CO
Marriage & Family Therapist 106H00000X MFT.0002440 CO Primary

Addresses

Primary practice location

300 Main St Ste 103
Grand Junction, CO 81501-2404

Mailing address

PO Box 41045
Grand Junction, CO 81504-1045

Other practice location 1

515 28 3/4 Rd
Grand Junction, CO 81501-5016
Phone (970) 241-6023

Other names 1

  • Teresa Dawn Beaty Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104002255 CO Practitioner - Marriage and Family Therapist 2163873050 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT.0002440COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado West Regional Mental Health, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Teresablacklmft, PLLC Marriage & Family Therapist CurrentSince Jun 23, 2025 Accepting new patients
Colorado West Regional Mental Health Inc. Current Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients
Colorado West Regional Mental Health, Inc. PastSince Aug 25, 2024 Accepting new patients
Colorado West Regional Mental Health, Inc. PastSince Jul 31, 2023 Accepting new patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients
Colorado West Regional Mental Health Inc. Past Accepting new patients
Colorado West Regional Mental Health, Inc. Past Accepting new patients

Locations

439 Breeze St
Ste 200
Craig, CO 81625
Phone (970) 824-6541

1560 Broadway
Denver, CO 80202
Phone (623) 363-6103

1560 Broadway
Ste 1600
Denver, CO 80202
Phone (303) 301-9929

2802 Grand Ave
Glenwood Springs, CO 81601
Phone (970) 945-2583

300 Main St
Ste 103
Grand Junction, CO 81501
Phone (970) 299-3307

707 Wapiti Ct
Rifle, CO 81650
Phone (970) 945-8683

707 Wapiti Ct
Unit 202B
Rifle, CO 81650
Phone (970) 625-3582

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1407368889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41045",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815041045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST STE 103",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012404",
            "telephone_number": "970-299-3307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 28 3/4 Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815015016",
            "country_code": "US",
            "telephone_number": "970-241-6023",
            "fax_number": "970-242-8330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "TERESA",
        "middle_name": "DAWN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-25",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "MFT.0002440",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "MFT.0002440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "BEATY",
            "middle_name": "DAWN",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.