Individual provider Active NPI

McCrae Merritt, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1144415092
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4726 Issued in CO
Practice address
1322 N. Academy Blvd.
Suite 200
Colorado Springs, CO 80909-3320
Phone
(719) 332-8090
Fax
(866) 678-4596
NPI assigned
Sep 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4726 CO Primary

Addresses

Primary practice location

1322 N. Academy Blvd.
Suite 200
Colorado Springs, CO 80909-3320

Mailing address

1322 N. Academy Blvd.
Suite 200
Colorado Springs, CO 80909-3320
Phone (719) 332-8090

Other names 1

  • Ms. McCrae Lightner Former name

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
I20250205004151 CO Practitioner - Mental Health Counselor 5294265203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

9362 Grand Cordera Pkwy
Suite 100
Colorado Springs, CO 80924-7007
Phone (888) 374-5066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4726COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Professional CurrentSince Dec 30, 2024 Accepting new patients
Family Care Center, LLC CurrentSince Dec 30, 2024 Accepting new patients
Diversus Health Inc Past Accepting new patients

Locations

9362 Grand Cordera Pkwy
Ste 100
Colorado Springs, CO 80924
Phone (719) 345-0429

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

Organizations & group practices 3

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": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1144415092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 N. ACADEMY BLVD.",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093320",
            "telephone_number": "719-332-8090",
            "fax_number": "866-678-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 N. ACADEMY BLVD.",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093320",
            "telephone_number": "719-332-8090",
            "fax_number": "866-678-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "MCCRAE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "4726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCCRAE",
            "last_name": "LIGHTNER",
            "prefix": "MS.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.