DR. CAROLYN LASTRA BLACK PSYD, LP
NPI 1508331257
Psychologist - Clinical in Brighton, CO

Q: What is Carolyn Black's NPI number?

The NPI number for Carolyn Black is 1508331257. It was assigned to this individual provider in the NPPES registry on October 9, 2018. The provider is also known as Carolyn Lastra Raffel Ma.

Q: What is Carolyn Black's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Carolyn Black enrolled in Medicare?

No. Carolyn Black has opted out of Medicare through January 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Carolyn Black was last updated on September 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 09, 2018Opted out of Medicare · through Jan 7, 2028

992 S 4TH AVE UNIT 100-218, BRIGHTON, CO 80601(720) 515-4291 Get Directions Write a Review

NPPES record last updated: September 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 7, 2025, Oct 13, 2024, Sep 4, 2024 and 5 more (8 updates tracked since 2018).

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About Dr. Carolyn Lastra Black Psyd, Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CAROLYN LASTRA BLACK PSYD, LP (NPI 1508331257) is an individual clinical provider in Brighton, Colorado, licensed in Colorado (PSY.0006222) and active in the NPI registry since October 2018. She has opted out of Medicare through January 7, 2028.

NPPES Registry Identity

NPI1508331257

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. CAROLYN LASTRA BLACKCredential: PSYD, LP

Location Address992 S 4TH AVE UNIT 100-218Brighton, CO 80601-6802

Mailing Address992 S 4th Ave Unit 100-218Brighton, CO 80601-6802 · (720) 515-4291

Phone(720) 515-4291

Sole ProprietorNo

Enumeration DateOctober 9, 2018

Last NPPES UpdateSeptember 7, 20258 updates tracked since enumeration

NPPES CertifiedSeptember 7, 2025

✔ NPI 1508331257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CO · PSY.0006222

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychologistTaxonomy 103T00000X · License PSY.0006222 (CO)

992 S 4TH AVE UNIT 100-218, Brighton, CO 80601

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Other Names 1

Former Name (1)Carolyn Lastra Raffel Ma

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Carolyn Lastra Black Psyd, Lp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 7, 2026 through January 7, 2028.

Opt-Out Effective DateJanuary 7, 2026

Opt-Out In Effect ThroughJanuary 7, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INTERWEAVE PSYCHOLOGY PLLC

Psychologist

992 S 4TH AVE UNIT 100-218
BRIGHTON, CO 80601

Adams County (720) 515-4291

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carolyn Black's NPI number?

The NPI number for Carolyn Black is 1508331257. It was assigned to this individual provider in the NPPES registry on October 9, 2018. The provider is also known as Carolyn Lastra Raffel Ma.

Where is Carolyn Black located?

Carolyn Black practices at 992 S 4th Ave Unit 100-218, Brighton, CO 80601. The listed phone number is (720) 515-4291.

What is Carolyn Black's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Carolyn Black enrolled in Medicare?

No. Carolyn Black has opted out of Medicare through January 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Carolyn Black was last updated on September 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.