Organization Active NPI

Breathe Counseling LLC

  • Professional Counselor
  • Greeley, CO
National Provider Identifier
1114698636
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BREATHE COUNSELING LLC
Practice address
4689 W 20TH St Unit E
Greeley, CO 80634-3218
Phone
(970) 381-2164
NPI assigned
Sep 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Ryan Andrew Smith, MA, LPCNPI 1912374844
Title
Owner
Phone
(970) 518-5266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary
Community/Behavioral Health Agency 251S00000X
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

4689 W 20TH St Unit E
Greeley, CO 80634-3218

Mailing address

3513 38TH Ave
Evans, CO 80620-9107
Phone (970) 518-5266

Other identifiers 1

IdentifierTypeStateIssuer
9000207559MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240325000024 CO Part B Supplier - Clinic/Group Practice 7315384526 Receives reassigned benefits from 1 practitioner
Practice locations: Greeley, CO

National Provider Directory

National Provider Directory

Locations

4625 W 20th St
#203B
Greeley, CO 80634

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1114698636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 38TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806209107",
            "telephone_number": "970-518-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4689 W 20TH ST UNIT E",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343218",
            "telephone_number": "970-381-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREATHE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-23",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-518-5266",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000207559",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.