NPIMap

Organization Active NPI

Lifespan Psychiatry of Colorado Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cortez, CO
National Provider Identifier
1578358263
Registry record updated Apr 12, 2025
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 INC.
Practice address
641 E Main St Unit a
Cortez, CO 81321-3349
Phone
(970) 579-0003
NPI assigned
Apr 12, 2025
Last updated
Apr 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFESPAN PSYCHIATRY OF COLORADO INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

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

Authorized official

Name
Carrie ShahbahramiNPI 1972070498
Title
Owner
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 NU Primary

Addresses

Primary practice location

641 E Main St Unit a
Cortez, CO 81321-3349

Mailing address

2140 N 12TH St
Grand Junction, CO 81501-2916

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

2140 N 12th St
Grand Junction, CO 81501
Phone (970) 712-6059

Practitioners & affiliated clinicians

Practitioners 5

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": "1744416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744416000000",
    "number": "1578358263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 N 12TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 E MAIN ST UNIT A",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213349",
            "telephone_number": "970-579-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN PSYCHIATRY OF COLORADO INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESPAN PSYCHIATRY OF COLORADO INC.",
        "enumeration_date": "2025-04-12",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "status": "A",
        "authorized_official_last_name": "SHAHBAHRAMI",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-579-0003"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortez, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; 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.