Individual provider Active NPI

Nicole Deherrera

  • Counselor
  • Centennial, CO
National Provider Identifier
1326672833
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
12385 Issued in CO
Practice address
6909 S Holly Cir Ste 304
Centennial, CO 80112-1045
Phone
(719) 593-5952
NPI assigned
Feb 24, 2020
Last updated
Feb 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 12385 CO Primary

Addresses

Primary practice location

6909 S Holly Cir Ste 304
Centennial, CO 80112-1045

Mailing address

6909 S Holly Cir Ste 304
Centennial, CO 80112-1045

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
I20250124003574 CO Practitioner - Mental Health Counselor 4486183118 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12385COMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Savio House, Inc. Professional Current Accepting new patients
Voyages Counseling Ministry Counselor CurrentSince Nov 23, 2024 Accepting new patients
Voyages Counseling Ministry CurrentSince Nov 23, 2024 Accepting new patients
Life Works Counseling CurrentSince Nov 19, 2023 Accepting new patients
Voyages Counseling Ministry Professional Past Accepting new patients

Locations

6909 S Holly Cir
Ste 304
Centennial, CO 80112
Phone (720) 729-7372

525 E Uintah St
Colorado Springs, CO 80903
Phone (303) 225-4100

5350 N Academy Blvd
Ste 200
Colorado Springs, CO 80918
Phone (719) 331-4175

325 King St
Denver, CO 80219
Phone (303) 225-4100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1326672833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6909 S HOLLY CIR STE 304",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6909 S HOLLY CIR STE 304",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121045",
            "telephone_number": "719-593-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHERRERA",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CO",
            "license": "12385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.