Alice Anne Boertje, MA, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC.0019250 Issued in CO

Practice address

128 S Tejon St Ste 405
Colorado Springs, CO 80903-2212

Phone

(312) 369-9422

Fax

(719) 755-4662

NPI assigned

Oct 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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.

• Formation Counseling Center

  • Mental Health Counselor
  • Colorado Springs, CO
  • NPI 1194403238
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1205478468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 S TEJON ST STE 405",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032212",
            "telephone_number": "312-369-9422",
            "fax_number": "719-755-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S TEJON ST STE 405",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032212",
            "telephone_number": "312-369-9422",
            "fax_number": "719-755-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERTJE",
        "first_name": "ALICE",
        "middle_name": "ANNE",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.014114",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0019250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF LICENSED PROFESSIONAL COUNSELING EXAMINERS",
            "identifier": "LPC.0019250",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC",
            "identifier": "180.014114",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayde Michelle Boehnke, NP
• Maren Boehnke, M.D.
• Mitchell Boehnke, MD
• Darci Boehringer
• Timothy W Boersma, DO
• Drew Boese
• Emma Boese, STUDENT
• Cynthia A Boffa-Schmidt, LCSW
• Matthew Bogans
• Nicole Hannah Boggan, MA, LPC

• Mental Health Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.