Abundant Life Therapy, LLC
Organization Active NPI Professional Counselor · Loveland, CO
NPI 1205314754 · NPPES record last updated Sep 1, 2020
Key facts
- NPI
- 1205314754
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- Legal business name
- ABUNDANT LIFE THERAPY, LLC
- Practice address
- 1401 S Taft Ave Ste 206
Loveland, CO 80537-6962 - Phone
- (307) 274-4398
- NPI assigned
- Aug 6, 2018
- Organization subpart
- No
Authorized official
- Name
- Debra Wilson
- Title
- Billing
- Phone
- (307) 222-2013
Practitioners 3
-
Christopher B Teipel, LPC, LAT
-
Karri Siebert, PPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CO, WY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240131004022 | CO | Part B Supplier - Clinic/Group Practice | 7517310097 |
Receives reassigned benefits from 1 practitioner Practice locations: Loveland, CO |
| O20240826000225 | WY | Part B Supplier - Clinic/Group Practice | 7517310097 |
Receives reassigned benefits from 2 practitioners Practice locations: Cheyenne, WY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Professional Counselor |
101YP2500X | Yes |
Addresses
Primary practice location
1401 S Taft Ave Ste 206
Loveland, CO 80537-6962
Mailing address
PO Box 21511
Cheyenne, WY 82003-7029
Phone (307) 274-4398
Other practice location 1
2321 Dunn Ave
Cheyenne, WY 82001-3214
Phone (307) 274-4398
Other providers in Loveland, CO
- Gabrielle Abney
- Abode Healthcare Colorado, Inc.
- Eva Joanne Abram
- John Abram
- Abundant Life Chiropractic LLC
- Accentcare Home Health of Mountain Valley, LLC
- Isabel Acevedo
- Jessica N Acidera
- Heather Ackley
- Acorn Behavioral Health Services LLC
All providers in Loveland, CO · Professional Counselor in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.