NPIMap

Organization Active NPI

Ark Valley Counseling & Supervision Services, LLC

Doing business as Ark Valley Counseling La Junta Office

  • Professional Counselor
  • La Junta, CO
National Provider Identifier
1053187963
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
ARK VALLEY COUNSELING & SUPERVISION SERVICES, LLC
Doing business as
Ark Valley Counseling La Junta Office
Practice address
317 W 3Rd St Ste 203
La Junta, CO 81050-1401
Phone
(719) 469-2670
NPI assigned
Dec 1, 2023
Last updated
Dec 1, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ARK VALLEY COUNSELING & SUPERVISION SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
Rayland L Smith, LPCNPI 1255615480
Title
Owner
Phone
(719) 468-7697

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
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

317 W 3Rd St Ste 203
La Junta, CO 81050-1401

Mailing address

24600 County Road 21
La Junta, CO 81050-9765
Phone (719) 469-2670

Other names 1

  • Ark Valley Counseling La Junta Office Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240305001005 CO Part B Supplier - Clinic/Group Practice 9133564743 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Junta, CO; Las Animas, CO

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ark Valley Counseling Supervision Services LLC6 organizations share this tax ID, including this one
Part of
Ark Valley Counseling Supervision Services LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

317 W 3rd St
Ste 203
La Junta, CO 81050
Phone (719) 469-2670

510 Carson Ave
Las Animas, CO 81054
Phone (719) 469-2670

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1053187963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24600 COUNTY ROAD 21",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810509765",
            "telephone_number": "719-469-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W 3RD ST STE 203",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810501401",
            "telephone_number": "719-469-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARK VALLEY COUNSELING & SUPERVISION SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARK VALLEY COUNSELING & SUPERVISION SERVICES, LLC",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RAYLAND",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-468-7697",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ark Valley Counseling La Junta Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Junta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.