Angelica Fedak, MA, LPCC, ADDC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0019010 Issued in CO

Practice address

649 Robert St
Longmont, CO 80503-9441

Phone

(720) 526-3284

NPI assigned

Apr 19, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

SKB TherapyGroup PAC ID 6507295912, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• SKB Therapy

  • Mental Health Counselor
  • Fort Collins, CO
  • NPI 1730711474
  Medicare reassignment Care Compare group NPD
• SKB Therapy

  • Mental Health Counselor
  • Loveland, CO
  • NPI 1477484384
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1427745504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 ROBERT ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805039441",
            "telephone_number": "720-526-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 ROBERT ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805039441",
            "telephone_number": "720-526-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDAK",
        "first_name": "ANGELICA",
        "credential": "MA, LPCC, ADDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0019010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Farmer, D.D.S.
• Leanna Jean Farrar, CD
• Tina Lee Farrell, MA, CCC-SLP
• Elizabeth Fauerbach
• Lora Faust, RN, CLC, CCCE
• Sonja Marie Feero, RPH
• Eric Feichtinger
• Michelle Fein
• Larissa Felt, RMT
• Judy Orletta Fenton, RN

• Mental Health Counselor in Longmont, CO
• Providers in Longmont, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.