Individual provider Active NPI

James B Cardinal

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1104284413
Registry record updated Oct 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPP1145 Issued in CO
Practice address
3585 Van Teylingen Dr Ste D
Colorado Springs, CO 80917-4872
Phone
(719) 413-5005
NPI assigned
Feb 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Mental Health Counselor 101YM0800X LPP1145 CO Primary

Addresses

Primary practice location

3585 Van Teylingen Dr Ste D
Colorado Springs, CO 80917-4872

Mailing address

4211 Hideout PL
Pueblo, CO 81008-1878
Phone (719) 240-2668

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
I20250626000847 CO Practitioner - Mental Health Counselor 9830552728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Diamond Global Healthcare IncGroup PAC ID 2466879713, 2 clinicians

Practice addresses (Care Compare)

3585 Van Teylingen Dr
Suite D
Colorado Springs, CO 80917-4872
Phone (719) 413-5005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPP1145COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
El Pueblo Boys' and Girls' Ranch, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696118400000",
    "number": "1104284413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 HIDEOUT PL",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081878",
            "telephone_number": "719-240-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 VAN TEYLINGEN DR STE D",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174872",
            "telephone_number": "719-413-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDINAL",
        "first_name": "JAMES",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-01",
        "last_updated": "2023-10-01",
        "certification_date": "2023-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPP1145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.