Individual provider Active NPI

Kevin Patrick Crosby

  • Professional Counselor
  • Trinidad, CO
National Provider Identifier
1235651670
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0003658 Issued in CO
Practice address
417 S Indiana Ave
Trinidad, CO 81082
Phone
(719) 846-4416
Fax
(719) 846-6408
NPI assigned
Jul 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 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 LPC.0003658 CO Primary

Addresses

Primary practice location

417 S Indiana Ave
Trinidad, CO 81082

Mailing address

41 Montebello Rd Ste 200
Pueblo, CO 81001-1366
Phone (719) 545-2746

Other practice location 1

926 Russell Ave
Walsenburg, CO 81089-2134
Phone (719) 738-2386

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231222003169 CO Practitioner - Mental Health Counselor 2163872623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health SolutionsGroup PAC ID 0143110668, 39 clinicians

Practice addresses (Care Compare)

417 S Indiana Ave
Rural Trinidad
Trinidad, CO 81082-3126
Phone (719) 846-4416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0003658COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Health Solutions CurrentSince Jan 1, 2024 Accepting new patients
Health Solutions CurrentSince Jan 1, 2024 Accepting new patients

Locations

1012 W Abriendo Ave
Pueblo, CO 81004
Phone (719) 583-2207

41 Montebello Rd
Ste 204
Pueblo, CO 81001
Phone (719) 423-1341

1302 Chinook Ln
Pueblo, CO 81001

2003 E 4th St
Pueblo, CO 81001
Phone (719) 544-6373

41 Montebello Rd
Ste 202
Pueblo, CO 81001
Phone (719) 423-1341

1304 Chinook Ln
Pueblo, CO 81001
Phone (719) 562-3222

41 Montebello Rd
Ste 100
Pueblo, CO 81001

41 Montebello Rd
Ste 116
Pueblo, CO 81001
Phone (719) 423-1500

41 Montebello Rd
Ste 104
Pueblo, CO 81001

1310 Chinook Ln
Pueblo, CO 81001

41 Montebello Rd
Ste 200
Pueblo, CO 81001
Phone (719) 545-1575

910 E Main St
Trinidad, CO 81082
Phone (719) 631-3370

417 S Indiana Ave
Trinidad, CO 81082
Phone (719) 846-4416

926 Russell Ave
Walsenburg, CO 81089
Phone (719) 738-2386

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1235651670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD STE 200",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011366",
            "telephone_number": "719-545-2746",
            "fax_number": "719-542-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 S INDIANA AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "81082",
            "telephone_number": "719-846-4416",
            "fax_number": "719-846-6408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "926 Russell Ave",
            "address_purpose": "LOCATION",
            "city": "Walsenburg",
            "state": "CO",
            "postal_code": "810892134",
            "country_code": "US",
            "telephone_number": "719-738-2386",
            "fax_number": "719-738-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-07",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0003658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinidad, CO

Sources for this page

Verify at the official NPI Registry.