Individual provider Active NPI

Laura T Fetters, MA, LPC,LAC

  • Addiction (Substance Use Disorder) Counselor
  • Colorado Springs, CO
National Provider Identifier
1265498943
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
90 Issued in CO
Practice address
703 N Tejon St Ste C
Colorado Springs, CO 80903-1050
Phone
(719) 636-9126
Fax
(719) 636-9127
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 90 CO Primary
Professional Counselor 101YP2500X 1680 CO

Addresses

Primary practice location

703 N Tejon St Ste C
Colorado Springs, CO 80903-1050

Mailing address

PO Box 60066
Colorado Springs, CO 80960-0066
Phone (719) 636-9126

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1680COMDAcupuncturist
90COMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Services PLLC Past Accepting new patients

Organizations & group practices 1

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1265498943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60066",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809600066",
            "telephone_number": "719-636-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N TEJON ST STE C",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031050",
            "telephone_number": "719-636-9126",
            "fax_number": "719-636-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERS",
        "first_name": "LAURA",
        "middle_name": "T",
        "credential": "MA, LPC,LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "90",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "1680",
            "primary": false
        }
    ],
    "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 Feb 4, 2021; 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.