Gerry Threatt, LMHC LH 61288295

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61288295 Issued in WA

Practice address

15 Grant St
Penrose, CO 81240-9643

Phone

(785) 375-2608

NPI assigned

Jun 9, 2020

Last updated

Jun 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, CO2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Mindful Therapy Group of Colorado, PCGroup PAC ID 3870036478, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Therapy Group of Colorado, PC

  • Clinical Social Worker
  • Greenwood Village, CO
  • NPI 1972389963

  Mental Health

  Medicare reassignment Care Compare group NPD
• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health

  Medicare reassignment Care Compare group NPD
• Mindful Therapy Group of Colorado, P.C.

  • Psychiatric/Mental Health Nurse Practitioner
  • Boulder, CO
  • NPI 1023971041

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1285259002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GRANT ST",
            "city": "PENROSE",
            "state": "CO",
            "postal_code": "812409643",
            "telephone_number": "785-375-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GRANT ST",
            "city": "PENROSE",
            "state": "CO",
            "postal_code": "812409643",
            "telephone_number": "785-375-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THREATT",
        "first_name": "GERRY",
        "name_prefix": "Mr.",
        "credential": "LMHC LH 61288295",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61288295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Penrose",
            "affiliation": "N",
            "endpointDescription": "Google Drive",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15 Grant St",
            "city": "Penrose",
            "state": "CO",
            "country_code": "US",
            "postal_code": "812409643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• MJM Contracting, Inc.
• Penrose Family Health Clinic
• Marissa Pope, LPC
• Dawn Rien
• Kimberly Rae Shaffer, ATC
• Alex R Vanacker, DDS

• Mental Health Counselor in Penrose, CO
• Providers in Penrose, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.