Organization Active NPI

Safe Harbours Counseling PLLC

  • Marriage & Family Therapist
  • Thornton, CO
National Provider Identifier
1124899141
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
SAFE HARBOURS COUNSELING PLLC
Practice address
12021 Pennsylvania St Ste 109a
Thornton, CO 80241-3151
Phone
(720) 842-2400
NPI assigned
Jan 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Althea M Bakke-Lysaker, PHDNPI 1154949311
Title
Owner
Phone
(720) 842-2400

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

12021 Pennsylvania St Ste 109a
Thornton, CO 80241-3151

Mailing address

12021 Pennsylvania St Ste 109a
Thornton, CO 80241-3151
Phone (720) 842-2400

Other identifiers 1

IdentifierTypeStateIssuer
MFT.0002278OtherCOLICENSE NO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240216001728 CO Part B Supplier - Clinic/Group Practice 8123462231 Receives reassigned benefits from 1 practitioner
Practice locations: Thornton, CO

National Provider Directory

National Provider Directory

Locations

12021 Pennsylvania St
Ste 109A
Thornton, CO 80241
Phone (720) 842-2400

Practitioners & affiliated clinicians

Practitioners 1

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": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1124899141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12021 PENNSYLVANIA ST STE 109A",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802413151",
            "telephone_number": "720-842-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 PENNSYLVANIA ST STE 109A",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802413151",
            "telephone_number": "720-842-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOURS COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "BAKKE-LYSAKER",
        "authorized_official_first_name": "ALTHEA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-842-2400",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO",
            "identifier": "MFT.0002278",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.