Individual provider Active NPI

Caroline Leach, MA CANDIDATE

  • Mental Health Counselor
  • Broomfield, CO
National Provider Identifier
1154711430
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC.0015356 Issued in CO
Practice address
2095 W 6TH Ave Ste 204
Broomfield, CO 80020-1880
Phone
(720) 387-8458
NPI assigned
Jan 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC.0015356 CO Primary

Addresses

Primary practice location

2095 W 6TH Ave Ste 204
Broomfield, CO 80020-1880

Mailing address

2095 W 6TH Ave Ste 204
Broomfield, CO 80020-1880
Phone (720) 432-7654

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

LicenseStateTypeSpecialty
LPC.0015356COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Mind Embodied PC Mental Health CurrentSince Jan 12, 2020 Accepting new patients
Dr. Sunda Friedman Tebockhorst Psychologicl Services, LTD Past Accepting new patients

Locations

2095 W 6th Ave
Ste 204
Broomfield, CO 80020
Phone (720) 387-8458

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1154711430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 W 6TH AVE STE 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201880",
            "telephone_number": "720-432-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 W 6TH AVE STE 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201880",
            "telephone_number": "720-387-8458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "CAROLINE",
        "credential": "MA CANDIDATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0015356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.