Individual provider Active NPI

Paige Leigh Baker Braxton, PSYD

  • Clinical Psychologist
  • Edwards, CO
National Provider Identifier
1952846255
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0005416 Issued in CO
Practice address
439 Edwards Access Rd
Edwards, CO 81632-5634
Phone
(970) 445-2489
NPI assigned
Dec 23, 2016
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0005416 CO Primary
Clinical Psychologist 103TC0700X 071.009442 IL

Addresses

Primary practice location

439 Edwards Access Rd
Edwards, CO 81632-5634

Mailing address

PO Box 4330
Avon, CO 81620-4330
Phone (970) 926-6340

Other practice location 1

1 E Superior St
Suite 306
Chicago, IL 60611-2507
Phone (312) 789-4532

Other practice location 2

20 N Clark St Ste 3600
Chicago, IL 60602-5088
Phone (239) 450-9207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220202001559 CO Practitioner - Clinical Psychologist 6507149689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.009442ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Valley Mental Health CurrentSince Aug 1, 2023 Accepting new patients
Eagle Valley Mental Health CurrentSince Aug 1, 2023 Accepting new patients
Leigh Kim Consulting, LLC Clinical Current Accepting new patients
Eagle Valley Mental Health Current Accepting new patients
Howard Brown Health Center Past Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

439 Edwards Access Rd
Edwards, CO 81632
Phone (970) 455-2489

181 W Meadow Dr
Vail, CO 81657
Phone (970) 476-1225

20 N Clark St
Ste 3600
Chicago, IL 60602
Phone (239) 450-9207

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1952846255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4330",
            "city": "AVON",
            "state": "CO",
            "postal_code": "816204330",
            "telephone_number": "970-926-6340",
            "fax_number": "970-926-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 EDWARDS ACCESS RD",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816325634",
            "telephone_number": "970-445-2489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Superior St",
            "address_2": "Suite 306",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112507",
            "country_code": "US",
            "telephone_number": "312-789-4532",
            "fax_number": "312-754-9402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 N Clark St Ste 3600",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606025088",
            "country_code": "US",
            "telephone_number": "239-450-9207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAXTON",
        "first_name": "PAIGE",
        "middle_name": "LEIGH BAKER",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-23",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0005416",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009442",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, CO

Sources for this page

Verify at the official NPI Registry.