Your Pediatric Psychologist, LLC

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

Legal business name

YOUR PEDIATRIC PSYCHOLOGIST, LLC

Practice address

1700 E 17TH Ave
Denver, CO 80218-1668

Phone

(720) 515-2535

NPI assigned

Sep 10, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jinsoon Lee, PSYD, MSCP, BCBNPI 1780851709

Title

Pediatric Health Psychologist

Phone

(720) 515-2535

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jinsoon Lee

  • Clinical Psychologist
  • Lone Tree, CO
  • NPI 1780851709
  NPD Authorized official

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1407461189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S GUN CLUB RD # K6-353",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165306",
            "telephone_number": "310-876-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E 17TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181668",
            "telephone_number": "720-515-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR PEDIATRIC PSYCHOLOGIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JINSOON",
        "authorized_official_title_or_position": "PEDIATRIC HEALTH PSYCHOLOGIST",
        "authorized_official_telephone_number": "720-515-2535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, MSCP, BCB"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@yourpediatricpsych.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email information",
            "address_1": "23951 E Ontario Pl",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800165945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Health Psychologist in Denver, CO
• Providers in Denver, CO by specialty
• Health Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.