Functional Lifestyle Systems Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2243 Issued in CO

Legal business name

FUNCTIONAL LIFESTYLE SYSTEMS INC

Practice address

503 Remington St Ste 102
Fort Collins, CO 80524-3089

Phone

(970) 690-9592

Fax

(970) 353-7888

NPI assigned

Oct 25, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Lori A. Perrin, PH.D.

Title

Psychologist

Phone

(970) 690-9592

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Lori A. Perrin, Ph.D. Doing business as
• Lori Perrin,Ph.D. Doing business as

Locations

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1861944977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 31ST AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346327",
            "telephone_number": "970-690-9592",
            "fax_number": "970-353-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 REMINGTON ST STE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243089",
            "telephone_number": "970-690-9592",
            "fax_number": "970-353-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL LIFESTYLE SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "PERRIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "970-690-9592",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60335378",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lori A. Perrin, Ph.D.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lori Perrin,Ph.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fred D Fuller, MA, LMFT
• Holly Fuller
• Jerome Fuller, IOMT
• James Wesley Fulton II, M.D.
• Jonelle Fulton, CNIM
• Kathleen Jeanette Fundalinski, FNP
• Haley Funk
• Danae Fuqua
• Michael A Fuqua
• Derek Gaarder, M.ED

• Psychologist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.