Active NPI
Carl Nassar
- Professional Counselor
- Fort Collins, CO
National Provider Identifier
1366076358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0004946
- Practice address
- 320 W Olive St
Fort Collins, CO 80521-2716 - Phone
- (970) 310-3406
- Fax
- (888) 965-4615
- NPI assigned
- Feb 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 0004946 | CO | Primary |
Addresses
Primary practice location
320 W Olive St
Fort Collins, CO 80521-2716
Mailing address
320 W Olive St
Fort Collins, CO 80521-2716
Phone (970) 310-3406
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 19, 2024 through Aug 19, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0004946 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582761600000",
"number": "1366076358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 W OLIVE ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805212716",
"telephone_number": "970-310-3406",
"fax_number": "888-965-4615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 W OLIVE ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805212716",
"telephone_number": "970-310-3406",
"fax_number": "888-965-4615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASSAR",
"first_name": "CARL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-27",
"last_updated": "2020-02-27",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "0004946",
"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 Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.