NPIMap

Organization Active NPI

Mycelium Psychology PLLC

  • Clinical Psychologist
  • Littleton, CO
National Provider Identifier
1649180142
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MYCELIUM PSYCHOLOGY PLLC
Practice address
5575 S Sycamore St Ste 200
Littleton, CO 80120-1146
Phone
(406) 540-5950
Fax
(406) 316-5991
NPI assigned
Sep 9, 2026
Last updated
Sep 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Dr. Jesse Fister, PHDNPI 1396439816
Title
Owner
Phone
(406) 540-5950

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
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

5575 S Sycamore St Ste 200
Littleton, CO 80120-1146

Mailing address

5575 S Sycamore St Ste 200
Littleton, CO 80120-1146
Phone (406) 540-5950

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1788912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1649180142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 S SYCAMORE ST STE 200",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801201146",
            "telephone_number": "406-540-5950",
            "fax_number": "406-316-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 S SYCAMORE ST STE 200",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801201146",
            "telephone_number": "406-540-5950",
            "fax_number": "406-316-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYCELIUM PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "FISTER",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-540-5950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.