Individual provider Active NPI

Katherine Smutka, MA, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1063711455
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0011468 Issued in CO
Practice address
875 W Moreno Ave
Colorado Springs, CO 80905-1731
Phone
(719) 572-6200
NPI assigned
Mar 24, 2011
Last updated
Jun 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X LPC.0011468 CO Primary

Addresses

Primary practice location

875 W Moreno Ave
Colorado Springs, CO 80905-1731

Mailing address

220 Ruskin Dr
Colorado Springs, CO 80910-2522
Phone (719) 572-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC.0011468COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Wellness Counseling Service, LLC Professional Past Accepting new patients

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, 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": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1063711455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RUSKIN DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809102522",
            "telephone_number": "719-572-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 W MORENO AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809051731",
            "telephone_number": "719-572-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMUTKA",
        "first_name": "KATHERINE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0011468",
            "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 Jun 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.