Individual provider Active NPI

William Mathew Ledoux, LPC

  • Mental Health Counselor
  • Pueblo, CO
National Provider Identifier
1194423749
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
14648 Issued in CO
Practice address
3528 Ringtail LN
Pueblo, CO 81005-3382
Phone
(719) 994-6819
NPI assigned
Feb 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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.0014648 CO
Mental Health Counselor 101YM0800X 14648 CO Primary

Addresses

Primary practice location

3528 Ringtail LN
Pueblo, CO 81005-3382

Mailing address

3528 Ringtail LN
Pueblo, CO 81005-3382
Phone (719) 994-6819

Other practice location 1

4112 Outlook Blvd Ste 303
Pueblo, CO 81008-1667
Phone (719) 557-8600

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
I20241014004075 CO Practitioner - Mental Health Counselor 4284166372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

4112 Outlook Blvd
Suite 303
Pueblo, CO 81008-1667
Phone (719) 557-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14648COMDMental Health Counselor
LPC.0014648COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Nov 1, 2024 Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

4112 Outlook Blvd
Ste 303
Pueblo, CO 81008
Phone (719) 557-8600

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 3

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": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1194423749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3528 RINGTAIL LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053382",
            "telephone_number": "719-994-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 RINGTAIL LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053382",
            "telephone_number": "719-994-6819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4112 Outlook Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810081667",
            "country_code": "US",
            "telephone_number": "719-557-8600",
            "fax_number": "719-557-8615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDOUX",
        "first_name": "WILLIAM",
        "middle_name": "MATHEW",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-22",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0014648",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "14648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.