Individual provider Active NPI

Crista L Studer, MS, LPC, RDN, CEDS-S

  • Mental Health Counselor
  • Boulder, CO
National Provider Identifier
1437621265
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701008078 Issued in VA
Practice address
1942 Broadway Ste 314C
Boulder, CO 80302-5233
Phone
(330) 703-0435
NPI assigned
Dec 18, 2018
Last updated
Jul 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701008078 VA Primary
Mental Health Counselor 101YM0800X LPC.0016174 CO
Mental Health Counselor 101YM0800X
Registered Dietitian 133V00000X 1044620
Registered Dietitian 133V00000X DI100000451 DC

Addresses

Primary practice location

1942 Broadway Ste 314C
Boulder, CO 80302-5233

Mailing address

808 S Arlington Mill Dr Apt 204
Arlington, VA 22204-6019

Other practice location 1

808 S Arlington Mill Dr Apt 204
Arlington, VA 22204-6019
Phone (720) 335-5880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 13, 2024 through Mar 13, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LPC.0016174COMDMental Health Counselor
0701008078VAMDMental Health Counselor
DI100000451DCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Serenity Counseling & Nutrition LLC Mental Health CurrentSince Jul 5, 2020 Accepting new patients

Locations

1942 Broadway
Ste 314C
Boulder, CO 80302
Phone (719) 203-1465

1530 Wilson Blvd
Ste 650
Arlington, VA 22209
Phone (571) 267-2325

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, 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": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1437621265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S ARLINGTON MILL DR APT 204",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222046019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 BROADWAY STE 314C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025233",
            "telephone_number": "330-703-0435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 S Arlington Mill Dr Apt 204",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222046019",
            "country_code": "US",
            "telephone_number": "720-335-5880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUDER",
        "first_name": "CRISTA",
        "middle_name": "L",
        "credential": "MS, LPC, RDN, CEDS-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701008078",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0016174",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "1044620",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DC",
            "license": "DI100000451",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.