Individual provider Active NPI

David Cole Awdish

  • Mental Health Counselor
  • Mancos, CO
National Provider Identifier
1174929558
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
104 S. Main St
Suite 3
Mancos, CO 81328-9033
Phone
(970) 403-5488
Fax
(970) 422-7236
NPI assigned
Nov 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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 Primary

Addresses

Primary practice location

104 S. Main St
Suite 3
Mancos, CO 81328-9033

Mailing address

844 Bauer Ave
Mancos, CO 81328-9255
Phone (970) 403-5485

Other practice location 1

2243 Main Ave
Durango, CO 81301-4699
Phone (970) 403-5488 ext. 1

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
I20250314003014 CO Practitioner - Mental Health Counselor 7719422831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cole Awdish LPC LLCGroup PAC ID 6901341023, 2 clinicians

Practice addresses (Care Compare)

104 S Main St
Suite 3
Mancos, CO 81328-9194
Phone (970) 403-5488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1174929558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 BAUER AVE",
            "city": "MANCOS",
            "state": "CO",
            "postal_code": "813289255",
            "telephone_number": "970-403-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S. MAIN ST",
            "address_2": "SUITE 3",
            "city": "MANCOS",
            "state": "CO",
            "postal_code": "813289033",
            "telephone_number": "970-403-5488",
            "fax_number": "970-422-7236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2243 Main Ave",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813014699",
            "country_code": "US",
            "telephone_number": "970-403-5488 x1",
            "fax_number": "970-422-7236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWDISH",
        "first_name": "DAVID",
        "middle_name": "COLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-12",
        "last_updated": "2024-06-06",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mancos, CO

Sources for this page

Verify at the official NPI Registry.