MEDICARE: LAKESIDE PSYCHOLOGICAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1568948776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKESIDE PSYCHOLOGICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	915 LAKESIDE CT
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81506-2815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3154 LAKESIDE DR APT 103
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81506
Country	:	US
Telephone Number	:	970-462-7206
Fax Number	:	970-628-4207

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. ROGER MILLER
Credential	:	PH.D.
Telephone Number	:	970-462-7206

Provider Enumeration Date	:	07/11/2018
Last Update Date	:	07/23/2018

Similar Medicare Providers

1790630192 — GRAND VILLA LIVING GROUP LLC
Practice Location Address:

2680 N 15TH ST
GRAND JUNCTION, CO
81506-4101

Practice Phone: 970-519-5725
Practice Fax:

1346760642 — MR. CHRISTOPHER LEWIS HOEF II LPN
Practice Location Address:

3031 N 14TH ST
GRAND JUNCTION, CO
81506

Practice Phone: 970-312-4442
Practice Fax:

1154323228 — DR. ERICK RENEE ARANEDA M.D.
Practice Location Address:

2643 PATTERSON RD , SUITE 605
GRAND JUNCTION, CO
81506-1936

Practice Phone: 970-244-2482
Practice Fax: 970-255-1701

1235134453 — DR. SCOTT E GRAY MD
Practice Location Address:

425 PATTERSON RD , SUITE 406
GRAND JUNCTION, CO
81506-1953

Practice Phone: 970-298-2275
Practice Fax: 970-298-7814

1780680405 — MARCIA ANN MENDENHALL PA
Practice Location Address:

1100 PATTERSON RD
GRAND JUNCTION, CO
81506-8219

Practice Phone: 970-244-6100
Practice Fax: 970-255-1809

1326047614 — SUMMITWEST CARE
Practice Location Address:

2800 PRINTERS WAY STE 200
GRAND JUNCTION, CO
81506-3944

Practice Phone: 970-263-0202
Practice Fax: 970-243-6855

1043219173 — DR. LAURIE ANN STEIN DDS
Practice Location Address:

500 PATTERSON RD , SUITE Z
GRAND JUNCTION, CO
81506-1962

Practice Phone: 970-241-1171
Practice Fax: 970-241-1261

Directions to “LAKESIDE PSYCHOLOGICAL SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.