Individual provider Active NPI

Julie Anne Braukhoff, LPC

  • Mental Health Counselor
  • Venice, FL
National Provider Identifier
1194871327
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2137 Issued in CO
Practice address
12161 Mercado Dr Unit 225
Venice, FL 34293-1147
Phone
(719) 635-0204
Fax
(303) 265-9858
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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 2137 CO Primary

Addresses

Primary practice location

12161 Mercado Dr Unit 225
Venice, FL 34293-1147

Mailing address

12161 Mercado Dr Unit 225
Venice, FL 34293-1147
Phone (719) 635-0204

Other practice location 1

2140 Academy Cir Ste F
Colorado Springs, CO 80909-1673
Phone (719) 635-0204

Other identifiers 1

IdentifierTypeStateIssuer
115227MedicaidCO

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

LicenseStateTypeSpecialty
2137COMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Starfish Counseling, PC Current Accepting new patients

Locations

1880 Dublin Blvd
Ste A
Colorado Springs, CO 80918
Phone (541) 351-9494

2140 Academy Cir
Ste F
Colorado Springs, CO 80909
Phone (719) 570-1225

12161 Mercado Dr
Venice, FL 34293
Phone (719) 635-0204

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1194871327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12161 MERCADO DR UNIT 225",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342931147",
            "telephone_number": "719-635-0204",
            "fax_number": "303-265-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12161 MERCADO DR UNIT 225",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342931147",
            "telephone_number": "719-635-0204",
            "fax_number": "303-265-9858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2140 Academy Cir Ste F",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809091673",
            "country_code": "US",
            "telephone_number": "719-635-0204",
            "fax_number": "303-265-9858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAUKHOFF",
        "first_name": "JULIE",
        "middle_name": "ANNE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "2137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115227",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.