Breanne Willey, LPC, NCC, CCM

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6225 Issued in CO

Practice address

7560 Rangewood Dr Ste 210
Colorado Springs, CO 80920-2100

Phone

(719) 659-1915

Fax

(888) 425-0383

NPI assigned

Oct 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Breanne Montgomery Former name

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

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Resolve Counseling, LLCGroup PAC ID 5991156093, 4 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 and National Provider Directory roles.

• Mindful Resolve Counseling, LLC

  • Professional Counselor
  • Colorado Springs, CO
  • NPI 1598390916
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1571443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1316580681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8756 DEL RIO RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808316799",
            "telephone_number": "719-659-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7560 RANGEWOOD DR STE 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202100",
            "telephone_number": "719-659-1915",
            "fax_number": "888-425-0383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8756 Del Rio Rd",
            "address_purpose": "LOCATION",
            "city": "Peyton",
            "state": "CO",
            "postal_code": "808316799",
            "country_code": "US",
            "telephone_number": "719-659-1915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLEY",
        "first_name": "BREANNE",
        "credential": "LPC, NCC, CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-19",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "17649",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "6225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316580681",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNE",
            "last_name": "MONTGOMERY",
            "credential": "LPC, NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willcat
• Kristen Wille
• Matthew Daniel Willemyns, PHARMD
• Carolyn Willett
• Lani Willette, DPT
• Benjamin Willford, DO
• William C Roth DDS PC
• William G. Shaner DDS, Ms, PC.
• William Guy Boniface LPC
• William Storms Allergy Clinic PC

• Professional Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.