Individual provider Active NPI

Alexandra Whiteley

  • Mental Health Counselor
  • Longmont, CO
National Provider Identifier
1336501428
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
720 100 Yearparty CT Ste 200
Longmont, CO 80504-8591
Phone
(720) 449-6676
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

720 100 Yearparty CT Ste 200
Longmont, CO 80504-8591

Mailing address

720 100 Yearparty CT Ste 200
Longmont, CO 80504-8591

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
I20241127002756 CO Practitioner - Mental Health Counselor 8921533902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lighthouse Neurofeedback and Behavior Analysis IncGroup PAC ID 5890220867, 2 clinicians

Practice addresses (Care Compare)

720 100 Yearparty CT
Suite 200
Longmont, CO 80504-8591
Phone (720) 295-7427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Neurofeedback & Behavior Analysis, Inc. Mental Health CurrentSince Sep 16, 2024 Accepting new patients

Locations

720 100 Year Party Ct
Ste 200
Longmont, CO 80504
Phone (720) 295-7427

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1336501428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 100 YEARPARTY CT STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805048591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 100 YEARPARTY CT STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805048591",
            "telephone_number": "720-449-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELEY",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.