Individual provider Active NPI

Nicole Hannah Boggan, MA, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1386202141
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0015431 Issued in CO
Practice address
6071 E Woodmen Rd Ste 145
Colorado Springs, CO 80923-2609
Phone
(719) 572-6100
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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.0015431 CO Primary

Addresses

Primary practice location

6071 E Woodmen Rd Ste 145
Colorado Springs, CO 80923-2609

Mailing address

220 Ruskin Dr
Colorado Springs, CO 80910-2522
Phone (719) 572-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LPC.0015431COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Diversus Health Inc Current Accepting new patients

Locations

460 County Road 43
Ste 7
Bailey, CO 80421
Phone (303) 838-5013

328 10th St
Calhan, CO 80808

115 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6340

413 Security Blvd
Colorado Springs, CO 80911

220 Ruskin Dr
Colorado Springs, CO 80910
Phone (719) 572-6150

875 W Moreno Ave
Colorado Springs, CO 80905
Phone (719) 572-6200

6208 Lehman Dr
Colorado Springs, CO 80918
Phone (719) 572-6133

1795 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 572-6111

179 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6300

18401 Highway 24
Ste 119
Woodland Park, CO 80863

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1386202141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RUSKIN DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809102522",
            "telephone_number": "719-572-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 E WOODMEN RD STE 145",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809232609",
            "telephone_number": "719-572-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGAN",
        "first_name": "NICOLE",
        "middle_name": "HANNAH",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0015431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.