MEDICARE: ERIE PSYCHIATRY, 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1699403980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIE PSYCHIATRY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1244
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-1244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 BRIGGS STREET
Second Line	:	SUITE B2
City	:	ERIE
State	:	CO
Zip	:	80516-5022
Country	:	US
Telephone Number	:	720-722-1584
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	DAVID BRADY
Credential	:
Telephone Number	:	720-722-1584

Provider Enumeration Date	:	08/12/2022
Last Update Date	:	04/09/2026

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Directions to “ERIE PSYCHIATRY, LLC ” Practice Location

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