Individual provider Active NPI

Mark Brothe, MA, CRC

  • Mental Health Counselor
  • Greeley, CO
National Provider Identifier
1447851373
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1300 N 17TH Ave
Greeley, CO 80631-9584
Phone
(970) 347-2120
NPI assigned
Nov 6, 2020
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 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 Primary

Addresses

Primary practice location

1300 N 17TH Ave
Greeley, CO 80631-9584

Mailing address

1300 N 17TH Ave
Greeley, CO 80631-9584
Phone (970) 347-2120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20240409001662 IL Practitioner - Mental Health Counselor 1254779317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bridgeway IncGroup PAC ID 4284627530, 6 clinicians

Practice addresses (Care Compare)

1235 W Carl Sandburg Dr
Galesburg, IL 61401-9780
Phone (309) 344-6207

137 E College
Kewanee, IL 61443-3703
Phone (309) 852-4331

1974 Windish Dr
Galesburg, IL 61401-9780
Phone (309) 344-4751

2062 E 1St St
Galesburg, IL 61401-9780
Phone (309) 344-6420

2323 Windish Dr
Galesburg, IL 61401-9780
Phone (309) 344-2323

301 Industrial Park Rd
Monmouth, IL 61462-9794
Phone (309) 734-9461

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeway Inc Mental Health CurrentSince Jan 31, 2024 Accepting new patients
Bridgeway Inc CurrentSince Jan 31, 2024 Accepting new patients
Bridgeway Inc Past Accepting new patients
Bridgeway Inc. Past Accepting new patients

Locations

2323 Windish Dr
Galesburg, IL 61401
Phone (309) 344-2323

137 E College St
Kewanee, IL 61443
Phone (309) 852-4331

301 Industrial Park Rd
Monmouth, IL 61462
Phone (309) 734-9461

Organizations & group practices 4

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": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1447851373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "970-347-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "970-347-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHE",
        "first_name": "MARK",
        "credential": "MA, CRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.