NPIMap

Organization Active NPI

La Luna Center, LLC

  • Group Psychotherapy Psychologist
  • Fort Collins, CO
National Provider Identifier
1336735950
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
Legal business name
LA LUNA CENTER, LLC
Practice address
2020 Caribou Dr Ste 201
Fort Collins, CO 80525-4352
Phone
(970) 282-8282
Fax
(303) 200-7098
NPI assigned
Dec 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Authorized official

Name
William Crisco
Title
Manager
Phone
(720) 470-3345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X Primary

Addresses

Primary practice location

2020 Caribou Dr Ste 201
Fort Collins, CO 80525-4352

Mailing address

2020 Caribou Dr Ste 201
Fort Collins, CO 80525-4352
Phone (970) 282-8282

National Provider Directory

National Provider Directory
Tax ID family
La Luna Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2020 Caribou Dr
Ste 201
Fort Collins, CO 80525
Phone (720) 289-6453

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1336735950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CARIBOU DR STE 201",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254352",
            "telephone_number": "970-282-8282",
            "fax_number": "303-200-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CARIBOU DR STE 201",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254352",
            "telephone_number": "970-282-8282",
            "fax_number": "303-200-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA LUNA CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "CRISCO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "720-470-3345"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.