Lakeside Psychological Services, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LAKESIDE PSYCHOLOGICAL SERVICES, LLC

Practice address

3154 Lakeside Dr Apt 103
Grand Junction, CO 81506

Phone

(970) 462-7206

Fax

(970) 628-4207

NPI assigned

Jul 11, 2018

Last updated

Jul 23, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roger Miller, PH.D.

Title

Clinical Psychologist

Phone

(970) 462-7206

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1568948776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 LAKESIDE CT",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815062815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3154 LAKESIDE DR APT 103",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81506",
            "telephone_number": "970-462-7206",
            "fax_number": "970-628-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "970-462-7206",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Lynn Ladd, RN, BSN
• Caroline West Laggis, MD
• Jordan Lagree
• Jason Lajoie
• Kristen Meredith Lake
• Abbey Elizabeth Lalone
• Shelby Lam
• Andrea Lamb, N.P.
• Jan Leah Lamb, D.O.
• Lexi Lambert

• Adult Mental Health Clinic/Center in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Adult Mental Health Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.