Individual provider Active NPI

Jessica Leah Brickey, LPC LAC

  • Professional Counselor
  • Fort Collins, CO
National Provider Identifier
1134575319
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0017289 Issued in CO
Practice address
4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone
(970) 494-4200
Fax
(844) 270-1824
NPI assigned
May 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0001886 CO
Driver 172A00000X
Professional Counselor 101YP2500X LPC.0017289 CO Primary

Addresses

Primary practice location

4856 Innovation Dr
Fort Collins, CO 80525-5539

Mailing address

4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone (970) 494-4200

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
I20240311003365 CO Practitioner - Mental Health Counselor 6709222847 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD.0001886COMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Summitstone Health Partners CurrentSince Jan 29, 2024 Accepting new patients
Summitstone Health Partners CurrentSince Jan 29, 2024 Accepting new patients
Longview Behavioral Health Past Accepting new patients
Longview Behavioral Health Professional Past Accepting new patients
Summitstone Health Partners Past Accepting new patients
Summitstone Health Partners Past Accepting new patients
Longview Behavioral Health Past Accepting new patients
Longview Behavioral Health Past Accepting new patients

Locations

1217 Riverside Ave
Fort Collins, CO 80524
Phone (970) 482-7800

4856 Innovation Dr
Ste B
Fort Collins, CO 80525
Phone (970) 397-7815

4102 S Timberline Rd
Fort Collins, CO 80525
Phone (970) 494-5728

4856 Innovation Dr
Fort Collins, CO 80525

1250 N Wilson Ave
Loveland, CO 80537
Phone (970) 494-9789

Organizations & group practices 8

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": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1134575319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "844-270-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "844-270-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKEY",
        "first_name": "JESSICA",
        "middle_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "LPC LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0001886",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0017289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.