Organization Active NPI

Mountain Air Counseling and Grief Therapy LLC

  • Social Worker
  • Windsor, CO
National Provider Identifier
1457070039
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
MOUNTAIN AIR COUNSELING AND GRIEF THERAPY LLC
Practice address
8010 S County Road 5 Unit 103
Windsor, CO 80528-9004
Phone
(307) 331-2862
NPI assigned
Aug 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Shannon Harris, LCSWNPI 1841774502
Title
Owner
Phone
(307) 331-2862

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

8010 S County Road 5 Unit 103
Windsor, CO 80528-9004

Mailing address

5095 Georgetown Dr
Loveland, CO 80538-6808
Phone (307) 331-2862

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719004109 CO Part B Supplier - Clinic/Group Practice 0648630848 Receives reassigned benefits from 1 practitioner
Practice locations: Loveland, CO

National Provider Directory

National Provider Directory

Locations

1001 E Harmony Rd
#A14
Fort Collins, CO 80525

150 E 29th St
Ste 215
Loveland, CO 80538
Phone (970) 342-5440

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1457070039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5095 GEORGETOWN DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805386808",
            "telephone_number": "307-331-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 S COUNTY ROAD 5 UNIT 103",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805289004",
            "telephone_number": "307-331-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN AIR COUNSELING AND GRIEF THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-331-2862",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.