Individual provider Active NPI

Marissa Halstead

  • Mental Health Counselor
  • Denver, CO
National Provider Identifier
1093459380
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC.0019193 Issued in CO
Practice address
400 S Colorado Blvd Ste 550
Denver, CO 80246-1255
Phone
(312) 772-9796
Fax
(312) 561-6974
NPI assigned
Apr 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCC.0019193 CO Primary

Addresses

Primary practice location

400 S Colorado Blvd Ste 550
Denver, CO 80246-1255

Mailing address

10815 Bayfield Way
Parker, CO 80138-3807
Phone (720) 448-3101

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

State licenses

LicenseStateTypeSpecialty
LPCC.0019193COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650672000000",
    "number": "1093459380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10815 BAYFIELD WAY",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801383807",
            "telephone_number": "720-448-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S COLORADO BLVD STE 550",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461255",
            "telephone_number": "312-772-9796",
            "fax_number": "312-561-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTEAD",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-23",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0019193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2022; 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.