New Frontiers Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

NEW FRONTIERS COUNSELING LLC

Practice address

105 S Main St
Fountain, CO 80817-2215

Phone

(719) 217-4609

Fax

(719) 362-4281

NPI assigned

Apr 3, 2024

Last updated

Aug 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew C Banach, LCSWNPI 1891255253

Title

Owner

Phone

(719) 217-4609

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Banach, LCSW

  • Clinical Social Worker
  • Fountain, CO
  • NPI 1891255253
  Medicare reassignment NPD Authorized official
• Trinda Hosselkus, MA LPC LAC

  • Professional Counselor
  • Canon City, CO
  • NPI 1861911315
  NPD (past)

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1194577098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S MAIN ST",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808172215",
            "telephone_number": "719-217-4609",
            "fax_number": "719-204-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S MAIN ST",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808172215",
            "telephone_number": "719-217-4609",
            "fax_number": "719-362-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW FRONTIERS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "BANACH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-217-4609",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Fountain, CO
• Providers in Fountain, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.