Individual provider Active NPI

Rebecca Kusick, MA, LPC

  • Mental Health Counselor
  • Broomfield, CO
National Provider Identifier
1386030468
Registry record updated Aug 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
799 Issued in CO
Practice address
80 Garden Ctr Ste 122
Broomfield, CO 80020-1735
Phone
(303) 907-6499
Fax
(855) 812-8339
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2020

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 799 CO Primary

Addresses

Primary practice location

80 Garden Ctr Ste 122
Broomfield, CO 80020-1735

Mailing address

PO Box 511
Broomfield, CO 80038-0511
Phone (303) 907-6499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 25, 2024 through Apr 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
799COMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Becky Kusick, Ma, LPC, Inc Mental Health CurrentSince Aug 30, 2020 Accepting new patients

Locations

80 Garden Ctr
Ste 122
Broomfield, CO 80020
Phone (303) 885-9588

Organizations & group practices 1

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1386030468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800380511",
            "telephone_number": "303-907-6499",
            "fax_number": "855-812-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GARDEN CTR STE 122",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201735",
            "telephone_number": "303-907-6499",
            "fax_number": "855-812-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSICK",
        "first_name": "REBECCA",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.