Individual provider Active NPI

Emilie M Ryan, LPC, MA

  • Professional Counselor
  • Fort Collins, CO
National Provider Identifier
1356717094
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0013811 Issued in CO
Practice address
242 Conifer St
Fort Collins, CO 80524-2043
Phone
(970) 494-4200
NPI assigned
Aug 17, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC.0013811 CO Primary

Addresses

Primary practice location

242 Conifer St
Fort Collins, CO 80524-2043

Mailing address

125 Crestridge St
Fort Collins, CO 80525-3934
Phone (970) 494-4200

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
I20240319000492 CO Practitioner - Mental Health Counselor 9931546520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2850 McClelland Dr
Suite 3400
Fort Collins, CO 80525-2572
Phone (866) 285-2929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC.0013811COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Polaris Partners Counseling and Consulting LLC Professional CurrentSince Feb 4, 2024 Accepting new patients
Polaris Partners Counseling and Consulting LLC Counselor CurrentSince Feb 4, 2024 Accepting new patients
Polaris Partners Counseling and Consulting LLC Professional Current Accepting new patients
Polaris Partners Counseling and Consulting LLC Professional Past Accepting new patients

Locations

155 S Madison St
Ste 306
Denver, CO 80209
Phone (970) 576-1717

2850 McClelland Dr
Ste 3400
Fort Collins, CO 80525
Phone (303) 345-8004

300 E Horsetooth Rd
Ste 200
Fort Collins, CO 80525
Phone (405) 474-4833

1502 S College Ave
Ste 3
Fort Collins, CO 80524

Organizations & group practices 4

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": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356717094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CRESTRIDGE ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253934",
            "telephone_number": "970-494-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 CONIFER ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242043",
            "telephone_number": "970-494-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "EMILIE",
        "middle_name": "M",
        "credential": "LPC, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0013811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.