Individual provider Active NPI

Dana Tsyconyea Starbyrd, LMHC, ATR-P, LMT, HT

  • Art Therapist
  • Longmont, CO
National Provider Identifier
1104447093
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
19-340 Issued in NM
Practice address
10900 Vermillion Rd
Longmont, CO 80504-9715
Phone
(928) 202-8173
NPI assigned
May 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CHM02007471 NM
Pastoral Counselor 101YP1600X CO
Massage Therapist 225700000X MT7360 NM
Massage Therapist 225700000X MT.0024579 CO
Art Therapist 221700000X 19-340 NM Primary

Addresses

Primary practice location

10900 Vermillion Rd
Longmont, CO 80504-9715

Mailing address

10900 Vermillion Rd
Longmont, CO 80504-9715
Phone (928) 202-8173

Other practice location 1

1650 38th St Ste 100
Boulder, CO 80301-2623
Phone (928) 202-8173

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
CHM02007471NMMDMental Health Counselor
19-340NMMDArt Therapist
MT.0024579COMDMassage Therapist
MT7360NMMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soulma LLC Art Therapist CurrentSince Nov 28, 2021 Accepting new patients
Santa Fe Integrative Therapy Art Therapist PastSince May 10, 2020 Accepting new patients

Locations

1650 38th St
Ste 100
Boulder, CO 80301
Phone (630) 414-8605

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": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1104447093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 VERMILLION RD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805049715",
            "telephone_number": "928-202-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 VERMILLION RD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805049715",
            "telephone_number": "928-202-8173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 38th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803012623",
            "country_code": "US",
            "telephone_number": "928-202-8173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARBYRD",
        "first_name": "DANA",
        "middle_name": "TSYCONYEA",
        "name_prefix": "Ms.",
        "credential": "LMHC, ATR-P, LMT, HT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CHM02007471",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "MT7360",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0024579",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NM",
            "license": "19-340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.