Individual provider Active NPI

Stephanie Lyn Dandurand, MS LPC

  • Professional Counselor
  • Fort Collins, CO
National Provider Identifier
1255624599
Registry record updated Jul 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC0011508 Issued in CO
Practice address
3351 Eastbrook Dr Ste 200
Fort Collins, CO 80525-5744
Phone
(970) 500-0164
NPI assigned
May 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9398 NE
Professional Counselor 101YP2500X LPC0011508 CO Primary

Addresses

Primary practice location

3351 Eastbrook Dr Ste 200
Fort Collins, CO 80525-5744

Mailing address

3351 Eastbrook Dr Ste 200
Fort Collins, CO 80525-5744
Phone (970) 500-0164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: No
  • 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
I20240103001916 CO Practitioner - Mental Health Counselor 3779933734 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9398NEMDMental Health Counselor
LPC0011508COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Family Care Center, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

3351 Eastbrook Dr
Ste 200
Fort Collins, CO 80525
Phone (970) 500-0164

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688169600000",
    "number": "1255624599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3351 EASTBROOK DR STE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255744",
            "telephone_number": "970-500-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 EASTBROOK DR STE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255744",
            "telephone_number": "970-500-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDURAND",
        "first_name": "STEPHANIE",
        "middle_name": "LYN",
        "credential": "MS LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2023-07-01",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "9398",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC0011508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.