Carolyn Lastra Black, PSYD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0006222 Issued in CO

Practice address

992 S 4TH Ave Unit 100-218
Brighton, CO 80601-6802

Phone

(720) 515-4291

NPI assigned

Oct 9, 2018

Last updated

Aug 30, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Carolyn Lastra Raffel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 7, 2026 through Jan 7, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Interweave Psychology PLLC

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  • NPI 1932889839

  Mental Health

  NPD Authorized official
• Insights

  • Cognitive & Behavioral Psychologist
  • Denver, CO
  • NPI 1811656465
  NPD (past)
• Insights, Colorado Assessment & Therapy

  dba Insights

  • Cognitive & Behavioral Psychologist
  • Denver, CO
  • NPI 1013324615
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788048000000",
    "number": "1508331257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11031 SHERIDAN BLVD STE 200",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800203437",
            "telephone_number": "720-515-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 S 4TH AVE UNIT 100-218",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806016802",
            "telephone_number": "720-515-4291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 30th St",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803011088",
            "country_code": "US",
            "telephone_number": "720-515-4291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CAROLYN",
        "middle_name": "LASTRA",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2026-08-30",
        "certification_date": "2026-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0006222",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "RAFFEL",
            "middle_name": "LASTRA",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Psychologist in Brighton, CO
• Providers in Brighton, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.