Active NPI
Laurie Liddick, MA
- Clinical Child & Adolescent Psychologist
- Parker, CO
National Provider Identifier
1548984099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 19563 E Mainstreet Ste 200
Parker, CO 80138-7394 - Phone
- (720) 441-3537
- NPI assigned
- Sep 28, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | CO | Primary |
Addresses
Primary practice location
19563 E Mainstreet Ste 200
Parker, CO 80138-7394
Mailing address
4541 Tennyson St
Denver, CO 80212-2526
Phone (970) 393-0188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 24, 2026 through Mar 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1548984099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4541 TENNYSON ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802122526",
"telephone_number": "970-393-0188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19563 E MAINSTREET STE 200",
"city": "PARKER",
"state": "CO",
"postal_code": "801387394",
"telephone_number": "720-441-3537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIDDICK",
"first_name": "LAURIE",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-28",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CO",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parker, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.