Individual provider Active NPI

Althea M Bakke-Lysaker, PHD

  • Marriage & Family Therapist
  • Thornton, CO
National Provider Identifier
1154949311
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2278 Issued in CO
Practice address
12021 Pennsylvania St Ste 109a
Thornton, CO 80241-3151
Phone
(720) 842-2400
NPI assigned
Jul 13, 2020
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0000273 CO
Marriage & Family Therapist 106H00000X 2278 CO 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 names 1

  • Dr. Ramy Bakke Professional 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
I20240226000863 CO Practitioner - Marriage and Family Therapist 2769826874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbours Counseling PLLC Marriage & Family Therapist CurrentSince Jan 9, 2024 Accepting new patients

Locations

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

Organizations & group practices 1

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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1154949311",
    "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": {
        "last_name": "BAKKE-LYSAKER",
        "first_name": "ALTHEA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "0000273",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "2278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAMY",
            "last_name": "BAKKE",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.