Active NPI
Anna Khandrueva, MSW, SWC
- Mental Health Counselor
- Broomfield, CO
National Provider Identifier
1174199210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- SWC.0000000324
- Practice address
- 80 Garden Ctr Ste 140
Broomfield, CO 80020-1790 - Phone
- (720) 340-2327
- NPI assigned
- May 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SWC.0000000324 | CO | Primary |
Addresses
Primary practice location
80 Garden Ctr Ste 140
Broomfield, CO 80020-1790
Mailing address
80 Garden Ctr Ste 140
Broomfield, CO 80020-1790
Phone (720) 340-2327
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SWC.0000000324 | CO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1174199210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 GARDEN CTR STE 140",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800201790",
"telephone_number": "720-340-2327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 GARDEN CTR STE 140",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800201790",
"telephone_number": "720-340-2327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHANDRUEVA",
"first_name": "ANNA",
"credential": "MSW, SWC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-30",
"last_updated": "2021-07-30",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "SWC.0000000324",
"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 Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.