Active NPI
Sam Dysart
- Professional Counselor
- Colorado Springs, CO
National Provider Identifier
1033080833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0022721
- Practice address
- 12295 Oracle Blvd Ste 340
Colorado Springs, CO 80921-3902 - Phone
- (719) 203-1856
- NPI assigned
- Sep 15, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC.0022721 | CO | Primary |
Addresses
Primary practice location
12295 Oracle Blvd Ste 340
Colorado Springs, CO 80921-3902
Mailing address
12295 Oracle Blvd Ste 340
Colorado Springs, CO 80921-3902
Phone (719) 203-1856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 13, 2025 through Oct 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC.0022721 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paraklete Counseling, PLLC | Professional | Current | Accepting new patients |
Locations
12295 Oracle Blvd
Ste 340
Colorado Springs, CO 80921
Phone (719) 203-1856
Organizations & group practices 1
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.
-
- Professional Counselor
- Colorado Springs, CO
- NPI 1366391583
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769040000000",
"number": "1033080833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12295 ORACLE BLVD STE 340",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809213902",
"telephone_number": "719-203-1856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12295 ORACLE BLVD STE 340",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809213902",
"telephone_number": "719-203-1856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYSART",
"first_name": "SAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-09-15",
"last_updated": "2026-01-22",
"certification_date": "2026-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0022721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.