YOUR PEDIATRIC PSYCHOLOGIST, LLC (NPI# 1407461189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407461189 |
| Entity Type | Organization |
| Organization Name | YOUR PEDIATRIC PSYCHOLOGIST, LLC |
| Practice Address |
1700 E 17th Ave Denver CO 80218-1668 |
| Mailing Address |
6140 S Gun Club Rd # K6-353 Aurora CO 80016-5306 |
| Practice Telephone | 7205152535 |
| Mailing Telephone | 3108764419 |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2020-09-14 |
| Authorized Official Name | DR. JINSOON LEE (PEDIATRIC HEALTH PSYCHOLOGIST) |
| Authorized Official Telephone | 7205152535 |
| Authorized Official Credential | PSYD, MSCP, BCB |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 103TH0004X |
Psychologist Specialization: Health |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Your Pediatric Psychologist, LLC | 6140 S Gun Club Rd, K6-353, Aurora, CO 80016 |
| Street Address |
1700 E 17TH AVE |
| City | DENVER |
| State | CO |
| Zip Code | 80218-1668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194356949 | Rebecca Russell | Physical Therapist | 1700 E 17th Ave, Denver, CO 80218-1668 | 2020-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598394462 | Robert Collins Taylor | Student in an Organized Health Care Education/Training Program | Family Medicine - Rainer General Surgery, 1960 Ogden Street, Suite 400, Denver, CO 80218 | 2020-04-03 |
| 1679136568 | Ayal Levi | Student in an Organized Health Care Education/Training Program | 1375 E. 19th Avenue Saint Joseph Hospital, Russell Pavillion, 2nd Floor Gme, Denver, CO 80218 | 2019-04-17 |
| 1588124408 | Leah Kellogg | Student in an Organized Health Care Education/Training Program | Bruner Family Medicine - 1960 Ogden St, Suite 460, Denver, CO 80218 | 2019-03-25 |
| 1316407828 | Brant Barry Hafen | Student in an Organized Health Care Education/Training Program | Family Medicine - Caritas Clinic, 1960 Ogden St., Suite 400, Denver, CO 80218 | 2019-03-21 |
| 1679058671 | Katarina Baldovin | Behavioral Analyst | 1430 Humboldt St, Apt 502, Denver, CO 80218 | 2018-09-26 |
| 1235677345 | Angelica Hollins Cunningham | Physical Therapist | 1830 N Franklin St Ste 400, Denver, CO 80218 | 2017-02-09 |
| 1104373786 | Anoush Simonyan | Counselor | 1724 Gilpin Street, Denver, CO 80218 | 2016-09-01 |
| 1881140143 | James Cole Abrams, LLC | Community/Behavioral Health | 1252 Corona St, Apt 4, Denver, CO 80218 | 2016-08-28 |
| 1316398167 | Joanna Ford Counseling | Community/Behavioral Health | 825 East Speer Blvd., 100b, Denver, CO 80218 | 2016-06-23 |
| 1487002671 | Anne Elizabeth Gulick | Physician Assistant | 1601 E 19th Ave, Suite 6600, Denver, CO 80218 | 2016-05-27 |
| Find all providers in zip 80218 | ||||
| Taxonomy Code | 103TH0004X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health |
| The distinct focus of the clinical health psychologist is on physical health problems. A clinical health psychologist has special expertise or training in clinical health psychology and applies scientific knowledge of the interrelationships among behavioral, emotional, cognitive, social and biological components in health and disease to the promotion and maintenance of health; the prevention, treatment and rehabilitation of illness and disability; and the improvement of the health care system. Clinical health psychologists are dedicated to the development of knowledge regarding the interface between behavior and health, and to the delivery of high quality services based on that knowledge to individuals, families, and health care. |
| Notes: Source: American Psychological Association Commission for the Recognition of Specialties and Proficiencies in Professional Psychology, 2008. [1/1/2007: new, 7/1/2008: definiton added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013300243 | Jessica Geller | Psychologist | 950 N Logan St Ste 101, Denver, CO 80203-3009 | 2015-03-12 |
| 1194030072 | Luis Carlos Richter | Psychologist | 929 Marion St, #311, Denver, CO 80218-3066 | 2010-08-16 |
| 1154623445 | Rachael Meir | Psychologist | 301 W 6th Ave, Denver, CO 80204-5182 | 2010-11-19 |
| 1831418789 | Michael Warren Stroud | Psychologist | 1055 Clermont St., 116b Denver Va Medical Center, Denver, CO 80220-3808 | 2010-05-18 |
| 1972820868 | Christopher W Stout | Psychologist | 950 E Harvard Ave, Ste 310, Denver, CO 80210-7009 | 2010-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497200984 | Mariana Iurcovich | Psychologist | 3132 29th St, Boulder, CO 80301-1324 | 2016-08-24 |
| 1295040913 | University of Colorado School of Medicine | Psychologist | 1784 Racine St, Room R09-130, Aurora, CO 80045-7144 | 2010-08-18 |
| 1831348754 | Angela G Green-dahnke | Psychologist | 15132 E. Hampden Ave, Suite G, Aurora, CO 80014 | 2008-09-16 |
| 1942306329 | Allison Marie Rottini | Psychologist | 123 Nw Aylesworth, Csu Health Network, Fort Collins, CO 80523 | 2006-09-15 |
| 1457910739 | Lauren Smith Pogue LLC | Psychologist | 2877 Main Ave, Durango, CO 81301-5936 | 2019-06-10 |
| 1134506496 | Lauren Marie Smith | Psychologist | 281 Sawyer Dr, #100, Durango, CO 81303-3409 | 2015-05-06 |
| 1053663161 | Jennifer Caspari | Psychologist | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2012-10-12 |
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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.