Individual provider Active NPI

Teryn Brodish

  • Addiction (Substance Use Disorder) Counselor
  • Fort Collins, CO
National Provider Identifier
1174149082
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ACD.0002596 Issued in CO
Practice address
1217 Riverside Ave
Fort Collins, CO 80524-3218
Phone
(970) 494-4200
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC.0023926 CO
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0002596 CO Primary

Addresses

Primary practice location

1217 Riverside Ave
Fort Collins, CO 80524-3218

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
I20250131001154 CO Practitioner - Mental Health Counselor 3779012067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summitstone Health PartnersGroup PAC ID 4284527144, 116 clinicians

Practice addresses (Care Compare)

1250 N Wilson Ave
Loveland, CO 80537-4461
Phone (970) 494-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD.0002596COMDAddiction (Substance Use Disorder) Counselor
LPCC.0022690COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Summitstone Health Partners CurrentSince Nov 29, 2024 Accepting new patients
Summitstone Health Partners CurrentSince Nov 29, 2024 Accepting new patients
Summitstone Health Partners Current Accepting new patients
Summitstone Health Partners Past Accepting new patients
Lake Whatcom Residential & Treatment Center Mental Health PastSince Jun 1, 2020 Accepting new patients
Summitstone Health Partners Past Accepting new patients

Locations

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 6

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": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1174149082",
    "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": "1217 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243218",
            "telephone_number": "970-494-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODISH",
        "first_name": "TERYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0023926",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0002596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.