Individual provider Active NPI

Jacque Ann Ristau, M.S.

  • Professional Counselor
  • Windsor, CO
National Provider Identifier
1083623235
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3173 Issued in CO
Practice address
1200 W Ash St
Ste D
Windsor, CO 80550-4652
Phone
(970) 222-7249
Fax
(970) 267-0830
NPI assigned
Aug 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3173 CO Primary

Addresses

Primary practice location

1200 W Ash St
Ste D
Windsor, CO 80550-4652

Mailing address

1200 W Ash St
Ste D
Windsor, CO 80550-4652
Phone (970) 222-7249

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
I20231219002449 CO Practitioner - Mental Health Counselor 4082064944 Practice locations: Windsor, CO

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Windsor, CO 80528
Phone (970) 222-7249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3173COMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083623235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W ASH ST",
            "address_2": "STE D",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805504652",
            "telephone_number": "970-222-7249",
            "fax_number": "970-267-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W ASH ST",
            "address_2": "STE D",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805504652",
            "telephone_number": "970-222-7249",
            "fax_number": "970-267-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTAU",
        "first_name": "JACQUE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "3173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CO

Sources for this page

Verify at the official NPI Registry.