Grace Elise Kackstaetter, MA, MFTC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFTC.0014626 Issued in CO

Practice address

10190 Bannock St Ste 120
Northglenn, CO 80260-6052

Phone

(970) 460-8009

NPI assigned

Jan 11, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Marriage and Family Therapist

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1003567041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 MT SNEFFELS AVE",
            "city": "SEVERANCE",
            "state": "CO",
            "postal_code": "805504888",
            "telephone_number": "801-708-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10190 BANNOCK ST STE 120",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802606052",
            "telephone_number": "970-460-8009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Mt Sneffels Ave",
            "address_purpose": "LOCATION",
            "city": "Severance",
            "state": "CO",
            "postal_code": "805504888",
            "country_code": "US",
            "telephone_number": "970-460-8009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 W 16th St Ste S",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806346872",
            "country_code": "US",
            "telephone_number": "970-460-8009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACKSTAETTER",
        "first_name": "GRACE",
        "middle_name": "ELISE",
        "credential": "MA, MFTC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "MFTC.0014626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary Jones
• Joseph Steven Arvay DC, PC
• Devyn Joseph
• Tia Joseph
• Jyoti Juneja, M.S.,CCC-A
• Courtney Kampert, MA CF-SLP
• Ashley Kane
• Sharada Kaphle Tripathi
• Johanna Karasik, MA, MCJ, LPC
• Gregory R Karraker, D.C.

• Mental Health Counselor in Northglenn, CO
• Providers in Northglenn, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.