Individual provider Active NPI

Ann Hagerty

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1336887231
Registry record updated May 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC.0019584 Issued in CO
Practice address
1283 Kelly Johnson Blvd Ste 200
Colorado Springs, CO 80920-3925
Phone
(719) 413-6776
NPI assigned
May 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2022

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 LPCC.0019584 CO Primary

Addresses

Primary practice location

1283 Kelly Johnson Blvd Ste 200
Colorado Springs, CO 80920-3925

Mailing address

103 Mesa Ave
Manitou Springs, CO 80829-1630

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
I20241107000311 CO Practitioner - Mental Health Counselor 3375077837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurofeedback Colorado Springs IncGroup PAC ID 0446660575, 6 clinicians

Practice addresses (Care Compare)

1283 Kelly Johnson Blvd
Suite 200
Colorado Springs, CO 80920-3925
Phone (719) 639-2928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCC.0019584COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Neurofeedback Colorado Springs, Inc. Mental Health CurrentSince Sep 1, 2024 Accepting new patients
Neurofeedback Colorado Springs, Inc. Mental Health PastSince May 29, 2022 Accepting new patients
Fellow Travelers LLC Past Accepting new patients

Locations

1283 Kelly Johnson Blvd
Ste 200
Colorado Springs, CO 80920
Phone (719) 413-6776

Organizations & group practices 3

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": "1653177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653177600000",
    "number": "1336887231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MESA AVE",
            "city": "MANITOU SPRINGS",
            "state": "CO",
            "postal_code": "808291630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 KELLY JOHNSON BLVD STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203925",
            "telephone_number": "719-413-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGERTY",
        "first_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-22",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0019584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.