Individual provider Active NPI

Kathryn J Dunham Coughlin, PSYD

  • Psychologist
  • Lakewood, CO
National Provider Identifier
1972861532
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY.0004446 Issued in CO
Practice address
11750 W 2ND PL
Lakewood, CO 80228-1575
Phone
(720) 321-8040
Fax
(720) 321-8041
NPI assigned
May 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4446 CO
Psychologist 103T00000X PSY.0004446 CO Primary

Addresses

Primary practice location

11750 W 2ND PL
Lakewood, CO 80228-1575

Mailing address

11750 W 2ND PL
Lakewood, CO 80228-1575
Phone (720) 321-8040

Other practice location 1

4141 E Dickenson Pl
Denver, CO 80222
Phone (303) 504-6500

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
I20170130001337 CO Practitioner - Clinical Psychologist 2961784830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portercare Adventist Health SystemGroup PAC ID 0941110886, 770 clinicians

Practice addresses (Care Compare)

2535 S Downing St
Denver, CO 80210-5850
Phone (303) 778-5797

7780 S Broadway
Littleton, CO 80122-2633

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4446COMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince May 31, 2025 Accepting new patients
Portercare Adventist Health System CurrentSince May 31, 2025 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Dunham Neuropsychological Services, LLC Current Accepting new patients

Locations

11750 W 2nd Pl
Ste 255
Lakewood, CO 80228
Phone (303) 629-5600

7780 S Broadway
Ste 350
Littleton, CO 80122
Phone (303) 734-8650

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1972861532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281575",
            "telephone_number": "720-321-8040",
            "fax_number": "720-321-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281575",
            "telephone_number": "720-321-8040",
            "fax_number": "720-321-8041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4141 E Dickenson Pl",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "80222",
            "country_code": "US",
            "telephone_number": "303-504-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNHAM COUGHLIN",
        "first_name": "KATHRYN",
        "middle_name": "J",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "4446",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0004446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.