MEDICARE: DR. LAURA MORGAN BEIDLEMAN

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	103T00000X	Psychologist	PSY.0006249	CO

General Provider Information

NPI Number	:	1750269767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA MORGAN BEIDLEMAN

Provider Business Mailing Address
First Line	:	PO BOX 260162
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-0162
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1464 S URBAN WAY
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-3912
Country	:	US
Telephone Number	:	808-429-0358
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	08/26/2025

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