Active NPI
Mary Gore
- Professional Counselor
- Brighton, CO
National Provider Identifier
1083354740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0017819
- Practice address
- 1611 Jennifer St
Brighton, CO 80601 - Phone
- (615) 582-0582
- NPI assigned
- Mar 30, 2022
- Sex
- Female
- 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 | 0017819 | CO | Primary |
Addresses
Primary practice location
1611 Jennifer St
Brighton, CO 80601
Mailing address
1611 Jennifer St
Brighton, CO 80601
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2026
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
275 S Main St
Suite 201
Longmont, CO 80501-6461
Phone (720) 707-1806
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0017819 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thornwoodwellnessllc | Current | Accepting new patients | |
| Thornwoodwellnessllc | Current | Accepting new patients |
Locations
275 S Main St
Ste 201
Longmont, CO 80501
Phone (303) 682-2440
225 W South Boulder Rd
Ste 103
Louisville, CO 80027
Phone (720) 709-2810
Organizations & group practices 2
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": "1648598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648598400000",
"number": "1083354740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 JENNIFER ST",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "80601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 JENNIFER ST",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "80601",
"telephone_number": "615-582-0582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORE",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-30",
"last_updated": "2022-03-30",
"certification_date": "2022-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "0017819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.