Individual provider Active NPI

Bernadette Pivarunas, PHD

  • Psychologist
  • Fort Collins, CO
National Provider Identifier
1316432842
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0006884 Issued in CO
Practice address
2001 S Shields St Ste 203
Fort Collins, CO 80526-1827
Phone
(970) 236-6317
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0015440 CO
Psychologist 103T00000X 0006884 CO Primary

Addresses

Primary practice location

2001 S Shields St Ste 203
Fort Collins, CO 80526-1827

Mailing address

2001 S Shields St Ste 203
Fort Collins, CO 80526-1827
Phone (970) 236-6317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240328000883 CO Practitioner - Mental Health Counselor 7214279504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2001 S Shields St
Fort Collins, CO 80526-1827
Phone (970) 236-6317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0006884COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Radical Healing LLC CurrentSince Sep 23, 2024 Accepting new patients
Radical Healing LLC Psychologist CurrentSince Feb 22, 2024 Accepting new patients

Locations

300 E Horsetooth Rd
Ste 200
Fort Collins, CO 80525
Phone (405) 474-4833

2001 S Shields St
Ste 203
Fort Collins, CO 80526
Phone (970) 236-6317

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1316432842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S SHIELDS ST STE 203",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261827",
            "telephone_number": "970-236-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S SHIELDS ST STE 203",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261827",
            "telephone_number": "970-236-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIVARUNAS",
        "first_name": "BERNADETTE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0015440",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "0006884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.