Active NPI
Marisela Pena, LPCC
- Mental Health Counselor
- Colorado Springs, CO
National Provider Identifier
1245895432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0015856
- Practice address
- 12295 Oracle Blvd
Colorado Springs, CO 80921-3903 - Phone
- (719) 452-4803
- NPI assigned
- May 3, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0015856 | CO | Primary |
Addresses
Primary practice location
12295 Oracle Blvd
Colorado Springs, CO 80921-3903
Mailing address
4065 New Santa Fe TRL
Colorado Springs, CO 80924-4403
Phone (719) 231-4263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 13, 2025 through Feb 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0015856 | CO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556841600000",
"number": "1245895432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4065 NEW SANTA FE TRL",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809244403",
"telephone_number": "719-231-4263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12295 ORACLE BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809213903",
"telephone_number": "719-452-4803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "MARISELA",
"name_prefix": "Mrs.",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-03",
"last_updated": "2019-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "0015856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.