Individual provider Active NPI

Marissa Rose Foster, MA, LPCC, NCC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1225537434
Registry record updated Feb 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0015219 Issued in CO
Practice address
5265 N Academy Blvd Ste 3200
Colorado Springs, CO 80918-4083
Phone
(719) 466-6854
NPI assigned
Feb 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0015219 CO Primary

Addresses

Primary practice location

5265 N Academy Blvd Ste 3200
Colorado Springs, CO 80918-4083

Mailing address

4646 N Crimson Cir
Colorado Springs, CO 80917-1607
Phone (719) 331-4748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240327000969 CO Practitioner - Mental Health Counselor 9830536770 Reassigns benefits to 1 organization
I20241223000114 KS Practitioner - Mental Health Counselor 9830536770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians
Sondermind PAGroup PAC ID 3577099621, 78 clinicians

Practice addresses (Care Compare)

720 S Colorado Blvd
PH North
Denver, CO 80246-1904
Phone (844) 843-7279

801 E Douglas Ave
FL 2
Wichita, KS 67202-3548
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0015219COMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Professional CurrentSince Mar 14, 2024 Accepting new patients
Sondermind, P.a. Mental Health CurrentSince Dec 1, 2024 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

801 E Douglas Ave
Fl 2
Wichita, KS 67202
Phone (316) 330-5353

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517616000000",
    "number": "1225537434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N CRIMSON CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809171607",
            "telephone_number": "719-331-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5265 N ACADEMY BLVD STE 3200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809184083",
            "telephone_number": "719-466-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "MARISSA",
        "middle_name": "ROSE",
        "credential": "MA, LPCC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-03",
        "last_updated": "2018-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0015219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.