NPIMap

Organization Active NPI

Lifespan Psychiatry of Colorado

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Delta, CO
National Provider Identifier
1407614365
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LIFESPAN PSYCHIATRY OF COLORADO
Practice address
555 Meeker St
Delta, CO 81416-1920
Phone
(970) 579-0003
NPI assigned
Mar 6, 2024
Last updated
Mar 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFESPAN PSYCHIATRY OF COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Carrie ShahbahramiNPI 1972070498
Title
Pmhnp
Phone
(970) 579-0003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

555 Meeker St
Delta, CO 81416-1920

Mailing address

1006 N 5TH St
Grand Junction, CO 81501-7561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Lifespan Psychiatry of Co

Locations

1006 N 5th St
Grand Junction, CO 81501
Phone (970) 640-4697

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1407614365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 N 5TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815017561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MEEKER ST",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814161920",
            "telephone_number": "970-579-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN PSYCHIATRY OF COLORADO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESPAN PSYCHIATRY OF COLORADO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "SHAHBAHRAMI",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "970-579-0003"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.