Individual provider Active NPI

Kiara Brie Ninos, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1023777513
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0014733 Issued in CO
Practice address
1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone
(719) 572-6100
NPI assigned
Dec 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0014733 CO Primary

Addresses

Primary practice location

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332

Mailing address

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone (719) 572-6100

Other practice location 1

1943 San Ildefonso Rd
Santa Fe, NM 87505-3343
Phone (505) 690-8891

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
I20240312002700 CO Practitioner - Mental Health Counselor 0547606675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diversus Health IncGroup PAC ID 7719879204, 49 clinicians

Practice addresses (Care Compare)

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone (719) 572-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0014733COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Diversus Health Inc Current Accepting new patients
Diversus Health Inc CurrentSince Feb 1, 2024 Accepting new patients
Diversus Health Inc CurrentSince Feb 1, 2024 Accepting new patients

Locations

460 County Road 43
Ste 7
Bailey, CO 80421
Phone (303) 838-5013

328 10th St
Calhan, CO 80808

6208 Lehman Dr
Colorado Springs, CO 80918
Phone (719) 572-6133

115 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6340

413 Security Blvd
Colorado Springs, CO 80911

220 Ruskin Dr
Colorado Springs, CO 80910
Phone (719) 572-6150

1795 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 572-6111

179 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6300

875 W Moreno Ave
Colorado Springs, CO 80905
Phone (719) 572-6200

18401 Highway 24
Ste 119
Woodland Park, CO 80863

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1023777513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1943 San Ildefonso Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875053343",
            "country_code": "US",
            "telephone_number": "505-690-8891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NINOS",
        "first_name": "KIARA",
        "middle_name": "BRIE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-11",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0014733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.