Individual provider Active NPI

Kristin Novotny

  • Counselor
  • Denver, CO
National Provider Identifier
1023631413
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC.0018384 Issued in CO
Practice address
4455 E 12TH Ave
Denver, CO 80220-2415
Phone
(303) 504-7700
NPI assigned
May 20, 2020
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC.0018384 CO Primary
Counselor 101Y00000X LPCC.0017359 CO
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

4455 E 12TH Ave
Denver, CO 80220-2415

Mailing address

4455 E 12TH Ave
Denver, CO 80220-2415
Phone (720) 545-4518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240112000085 CO Practitioner - Mental Health Counselor 5799136982 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0018384COMDCounselor
LPCC.0017359COMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of Denver Current Accepting new patients
Mental Health Center of Denver CurrentSince Jan 1, 2024 Accepting new patients
Mental Health Center of Denver CurrentSince Jan 1, 2024 Accepting new patients

Locations

4141 E Dickenson Pl
Denver, CO 80222
Phone (303) 504-6509

4455 E 12th Ave
Denver, CO 80220
Phone (303) 504-7799

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1023631413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "720-545-4518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "303-504-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "KRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CO",
            "license": "LPC.0018384",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CO",
            "license": "LPCC.0017359",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.