LAKESIDE PSYCHOLOGICAL SERVICES, LLC (NPI# 1568948776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568948776 |
| Entity Type | Organization |
| Organization Name | LAKESIDE PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
3154 Lakeside Dr Apt 103 Grand Junction CO 81506 |
| Mailing Address |
915 Lakeside Ct Grand Junction CO 81506-2815 |
| Practice Telephone | 9704627206 |
| Practice Fax Number | 9706284207 |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | DR. ROGER MILLER (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 9704627206 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Lakeside Psychological Services, LLC | 3154 Lakeside Drive, Suite 103, Grand Junction, CO 81506 |
| Street Address |
3154 LAKESIDE DR APT 103 |
| City | GRAND JUNCTION |
| State | CO |
| Zip Code | 81506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134783756 | Tanya Lynn Christians | Massage Therapist | 3154 Lakeside Dr Apt 103, Grand Junction, CO 81506-2841 | 2019-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759820 | Dana Patton | Student in an Organized Health Care Education/Training Program | St. Mary's Family Medicine Center, 2698 Patterson Road, Grand Junction, CO 81506 | 2020-04-23 |
| 1720646292 | Creed Ott | Family Medicine | 2698 Patterson Road, Grand Junction, CO 81506 | 2019-05-30 |
| 1700389095 | Catherine Martha Plough | Registered Nurse | 2754 Compass Drive, Suite 377, Grand Junction, CO 81506 | 2018-03-13 |
| 1114445657 | Katrina Nicol Metcalf | Nurse Practitioner | 2643 Patterson Road Suite 605, Grand Junction, CO 81506 | 2017-09-05 |
| 1346760642 | Christopher Lewis Hoef II | Licensed Practical Nurse | 3031 N 14th St, Grand Junction, CO 81506 | 2017-06-27 |
| 1477928976 | Welbrook Senior Living Grand Junction LLC | Skilled Nursing Facility | 2596 Patterson Rd., Grand Junction, CO 81506 | 2015-12-09 |
| 1073902284 | Brett Adams | Audiologist-Hearing Aid Fitter | 2643 Patterson Rd Ste 503, Grand Junction, CO 81506 | 2015-01-12 |
| 1942625116 | Pamela W Kreps | Hearing Instrument Specialist | 759 Horizon Dr Ste E, Grand Junction, CO 81506 | 2014-02-25 |
| 1962779249 | Premere Rehab LLC | Occupational Therapist | 625 271/2 Road, Grand Junction, CO 81506 | 2011-11-30 |
| 1811207137 | Brenda Marie Watson | Counselor | 669 Jubilee Ct, Grand Junciton, CO 81506 | 2010-10-20 |
| Find all providers in zip 81506 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770190464 | The Synergy Services | Clinic/Center | 2646 Patterson Rd Apt B, Grand Junction, CO 81506-1994 | 2020-09-26 |
| 1871047746 | Grand Rver Psychiatry | Clinic/Center | 743 Horizon Ct, Grand Junction, CO 81506-8701 | 2016-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861009391 | Mindfulness Based Interventions LLC | Clinic/Center | 640 Sherman St., Unit H, Ridgway, CO 81432 | 2020-09-29 |
| 1447866876 | Wholehearted Therapy LLC | Clinic/Center | 7150 E Hampden Ave Ste 307, Denver, CO 80224-3057 | 2020-09-21 |
| 1902418965 | Klarisana Physician Services Pllc | Clinic/Center | 5005 W 81st Pl Ste 403, Westminster, CO 80031-7025 | 2020-08-20 |
| 1033736699 | A Phoenix Rising, LLC | Clinic/Center | 731 N Weber St Ste 211, Colorado Springs, CO 80903-1019 | 2020-06-30 |
| 1003433947 | Key Counseling, LLC. | Clinic/Center | 3705 Kipling, Optional, Wheat Ridge, CO 80033-8003 | 2020-06-26 |
| 1225653413 | Awake Mindful Therapy | Clinic/Center | 30922 Hilltop Dr, Evergreen, CO 80439-8762 | 2020-06-12 |
| 1154941540 | Galia R. Abadi Inc. | Clinic/Center | 4155 E Jewell Ave Ste 1004, Denver, CO 80222-4514 | 2020-04-25 |
| 1063047900 | Map and The Mirror Counseling, LLC | Clinic/Center | 911 Two Rivers Dr, Telluride, CO 81435-9152 | 2020-03-11 |
| 1306478961 | Specialized Alternatives for Families and Youth of Colorado, Inc. | Clinic/Center | 12500 E Iliff Ave Ste 110, Aurora, CO 80014-1268 | 2020-02-11 |
| 1508497348 | Josmar Trejo-sanchez | Clinic/Center | 2460 W 26th Ave Ste 217c, Denver, CO 80211-5312 | 2020-01-30 |
| Find all providers with the same taxonomy | ||||
| City | GRAND JUNCTION |
| Zip Code | 81506 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.