Individual provider Active NPI

Keegan Maverick Meadows

  • Mental Health Counselor
  • Boulder, CO
National Provider Identifier
1265155162
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC.0023464 Issued in CO
Practice address
2955 Valmont Rd Ste 310
Boulder, CO 80301-1360
Phone
(720) 440-2066
NPI assigned
Sep 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCC.0023464 CO Primary

Addresses

Primary practice location

2955 Valmont Rd Ste 310
Boulder, CO 80301-1360

Mailing address

2955 Valmont Rd Ste 310
Boulder, CO 80301-1360
Phone (720) 440-2066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPCC.0023464COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1265155162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 VALMONT RD STE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011360",
            "telephone_number": "720-440-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 VALMONT RD STE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011360",
            "telephone_number": "720-440-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOWS",
        "first_name": "KEEGAN",
        "middle_name": "MAVERICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-26",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0023464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.