Active NPI
Elaine Sandra Pickett, M.A.
- Professional Counselor
- Fort Collins, CO
National Provider Identifier
1114101847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1137
- Practice address
- 1644 S College Ave
Fort Collins, CO 80525-1007 - Phone
- (970) 221-4040
- NPI assigned
- Dec 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 1137 | CO | Primary |
Addresses
Primary practice location
1644 S College Ave
Fort Collins, CO 80525-1007
Mailing address
1644 S College Ave
Fort Collins, CO 80525-1007
Phone (970) 221-4040
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1137 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1114101847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1644 S COLLEGE AVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805251007",
"telephone_number": "970-221-4040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1644 S COLLEGE AVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805251007",
"telephone_number": "970-221-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICKETT",
"first_name": "ELAINE",
"middle_name": "SANDRA",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-17",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "1137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.