Lisa Marr, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY.0004733 Issued in CO

Practice address

312 5TH Street
Walden, CO 80480

Phone

(970) 457-0618

NPI assigned

Feb 20, 2018

Last updated

Mar 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dove Haven LLC

  • Psychologist
  • Walden, CO
  • NPI 1194215939
  NPD Authorized official

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1942700422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882",
            "city": "WALDEN",
            "state": "CO",
            "postal_code": "804800882",
            "telephone_number": "720-810-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 5TH STREET",
            "city": "WALDEN",
            "state": "CO",
            "postal_code": "80480",
            "telephone_number": "970-457-0618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 W Main St",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "CO",
            "postal_code": "807513168",
            "country_code": "US",
            "telephone_number": "970-522-4549",
            "fax_number": "970-522-6898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 East Colfax Avenue",
            "address_purpose": "LOCATION",
            "city": "Bennett",
            "state": "CO",
            "postal_code": "80102",
            "country_code": "US",
            "telephone_number": "720-810-1386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARR",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0004733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Walden",
            "affiliation": "N",
            "address_1": "312 5th Street",
            "city": "Walden",
            "state": "CO",
            "country_code": "US",
            "postal_code": "80480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dove Haven LLC
• Carol Ann Flynn, LMT
• Tamera Lynn Gildenzoph, MA
• Kali Kenady, NA
• Kremmling Memorial Hospital District (North Park Medical Center - Walden)
• Never Summer Dental Hygiene
• North Park Hospital District
• North Park Medical Clinic, Inc

• Psychologist in Walden, CO
• Providers in Walden, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.