Active NPI
Naomi Kettner
- Professional Counselor
- Colorado Springs, CO
National Provider Identifier
1356858351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0019996
- Practice address
- 825 Citadel Dr E Ste 250
Colorado Springs, CO 80909-5488 - Phone
- (719) 345-2424
- NPI assigned
- Dec 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC.0019996 | CO | Primary |
Addresses
Primary practice location
825 Citadel Dr E Ste 250
Colorado Springs, CO 80909-5488
Mailing address
3128 Banjo Dr
Colorado Springs, CO 80918-1689
Phone (719) 271-4614
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC.0019996 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Overcomers Counseling | Professional | Current | Accepting new patients |
| Overcomers Counseling | Professional | Past | Accepting new patients |
Locations
825 Citadel Dr E
Ste 250
Colorado Springs, CO 80909
Phone (719) 345-2424
Organizations & group practices 2
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.
-
- Professional Counselor
- Colorado Springs, CO
- NPI 1760200505
-
- Professional Counselor
- Colorado Springs, CO
- NPI 1568016038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699488000000",
"number": "1356858351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3128 BANJO DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809181689",
"telephone_number": "719-271-4614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 CITADEL DR E STE 250",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809095488",
"telephone_number": "719-345-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETTNER",
"first_name": "NAOMI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-29",
"last_updated": "2023-11-09",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0019996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.