Provider Demographics
NPI:1871151308
Name:MOUNTAIN PSYCHIATRY
Entity type:Organization
Organization Name:MOUNTAIN PSYCHIATRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHILD AND FAMILY PSYCHIATRIC NP
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:LIPPINCOTT
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS, PMHNP-BC
Authorized Official - Phone:510-427-2896
Mailing Address - Street 1:1905 15TH ST UNIT 489
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5413
Mailing Address - Country:US
Mailing Address - Phone:303-857-5260
Mailing Address - Fax:
Practice Address - Street 1:1905 15TH ST UNIT 489
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5413
Practice Address - Country:US
Practice Address - Phone:510-427-2896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty