Lisa M. Vonderhaar, PH.D.,LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2106 Issued in CO

Legal business name

LISA M. VONDERHAAR, PH.D.,LLC

Practice address

10291 Chippewa Cir
Salida, CO 81201-9596

Phone

(970) 531-0574

NPI assigned

Apr 22, 2013

Organization subpart

No

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

Authorized official

Name

Lisa Maret Vonderhaar, PH.D.NPI 1114086410

Title

Owner/Psychologist

Phone

(970) 531-0574

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Maret Vonderhaar, PH.D.

  • Clinical Psychologist
  • Salida, CO
  • NPI 1114086410
  Medicare reassignment Authorized official
• Sara Papathakis, LCSW

  • Clinical Social Worker
  • Salida, CO
  • NPI 1295486793
  NPD (past)

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1912341983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10291 CHIPPEWA CIR",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812019596",
            "telephone_number": "970-531-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10291 CHIPPEWA CIR",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812019596",
            "telephone_number": "970-531-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA M. VONDERHAAR, PH.D.,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "VONDERHAAR",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARET",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "970-531-0574",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Leong
• Suzanne Rene Lesage, M.D.
• Life Care Centers of America, Inc.
• Lifehouse Medicine, PLLC
• Deborah M Lince, MD
• Darcie Livingston, RN, BSN
• LJCC Services, LLC
• LJCC Services, LLC
• Edwin J Loeffel Jr., MD
• Christina Alvord Logan, MS, OTR/L

• Clinical Psychologist in Salida, CO
• Providers in Salida, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.