Individual provider Active NPI

Emily Mickley, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Englewood, CO
National Provider Identifier
1376354688
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.1000552-NP Issued in CO
Practice address
3726 1/2 S Lincoln St
Englewood, CO 80113-3622
Phone
(720) 352-3564
NPI assigned
Jan 16, 2025
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.1000552-NP CO Primary

Addresses

Primary practice location

3726 1/2 S Lincoln St
Englewood, CO 80113-3622

Mailing address

3726 1/2 S Lincoln St
Englewood, CO 80113-3622

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909003314 CO Practitioner - Nurse Practitioner 0143723932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1516 Lake Vista Way
Severance, CO 80550-3804

2120 Milestone Dr
Suite 103
Fort Collins, CO 80525-5756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Counseling and Consulting LLC CurrentSince Aug 1, 2025 Accepting new patients
Momentum Counseling and Consulting LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

2120 Milestone Dr
Ste 103
Fort Collins, CO 80525
Phone (719) 789-7041

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, 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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1376354688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 1/2 S LINCOLN ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 1/2 S LINCOLN ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133622",
            "telephone_number": "720-352-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLEY",
        "first_name": "EMILY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.1000552-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.