Organization Active NPI

Skyline Counseling and Consulting

  • Adult Mental Health Clinic/Center
  • Canon City, CO
National Provider Identifier
1023740370
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SKYLINE COUNSELING AND CONSULTING
Practice address
420 Pike Ave
Canon City, CO 81212-3134
Phone
(719) 371-1435
NPI assigned
Jun 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Authorized official

Name
Trinda Hosselkus, MA, LPC-S, LACNPI 1861911315
Title
Owner
Phone
(719) 371-1435

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

420 Pike Ave
Canon City, CO 81212-3134

Mailing address

420 Pike Ave
Canon City, CO 81212-3134

Other identifiers 1

IdentifierTypeStateIssuer
9009000192483MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skylinecounselingandconsulting@skylcc.org Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241001003987 CO Part B Supplier - Clinic/Group Practice 5597296590 Receives reassigned benefits from 1 practitioner
Practice locations: Canon City, CO

National Provider Directory

National Provider Directory

Locations

831 Royal Gorge Blvd
Ste 222
Canon City, CO 81212
Phone (719) 371-1435

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1023740370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 PIKE AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 PIKE AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123134",
            "telephone_number": "719-371-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE COUNSELING AND CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "HOSSELKUS",
        "authorized_official_first_name": "TRINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-371-1435",
        "authorized_official_credential": "MA, LPC-S, LAC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9009000192483",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skylinecounselingandconsulting@skylcc.org",
            "affiliation": "N",
            "endpointDescription": "Counseling Service",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "420 Pike Ave",
            "city": "Canon City",
            "state": "CO",
            "country_code": "US",
            "postal_code": "812123134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.