Healthcare Provider Details

I. General information

NPI: 1518901693
Provider Name (Legal Business Name): DARREN L LISH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2329 WOODBURY LN
EVERGREEN CO
80439-9442
US

IV. Provider business mailing address

2329 WOODBURY LN
EVERGREEN CO
80439-9442
US

V. Phone/Fax

Practice location:
  • Phone: 303-827-9803
  • Fax:
Mailing address:
  • Phone: 303-827-9803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberS4339
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0044260
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number041609
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: