Individual provider Active NPI

Elizabeth Moffitt, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1417694167
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
3361 N Academy Blvd
Colorado Springs, CO 80917-5103
Phone
(719) 285-7466
NPI assigned
May 15, 2022
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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 NU Primary

Addresses

Primary practice location

3361 N Academy Blvd
Colorado Springs, CO 80917-5103

Mailing address

3361 N Academy Blvd
Colorado Springs, CO 80917-5103
Phone (719) 285-7466

Other practice location 1

10 Boulder Crescent St Ste 102E
Colorado Springs, CO 80903-3339
Phone (719) 285-7466

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL coexperientialcounseling.com Direct

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: Yes
  • 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, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3361 N Academy Blvd
Colorado Springs, CO 80917-5103

5687 Sunshade PT
Colorado Springs, CO 80923-7570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Living Water Trauma Counseling and Consulting, PLLC Current Accepting new patients
Colorado Experiential Counseling, LLC Professional CurrentSince Jan 6, 2022 Accepting new patients

Locations

3361 N Academy Blvd
Colorado Springs, CO 80917
Phone (719) 285-7466

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": "1652572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1417694167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175103",
            "telephone_number": "719-285-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3361 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175103",
            "telephone_number": "719-285-7466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Boulder Crescent St Ste 102E",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809033339",
            "country_code": "US",
            "telephone_number": "719-285-7466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOFFITT",
        "first_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-15",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "coexperientialcounseling.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3361 N Academy Blvd",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809175103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.