Organization Active NPI

Mountaineer Counseling and Consulting, LLC

  • Psychologist
  • Colorado Springs, CO
National Provider Identifier
1477080430
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2835 Issued in CO
Legal business name
MOUNTAINEER COUNSELING AND CONSULTING, LLC
Practice address
7855 Pine Cone Rd
Colorado Springs, CO 80908-6117
Phone
(719) 338-4665
NPI assigned
May 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
Dr. David C. Solly, EDDNPI 1942400270
Title
Owner
Phone
(719) 338-4665

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
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 2835 CO Primary

Addresses

Primary practice location

7855 Pine Cone Rd
Colorado Springs, CO 80908-6117

Mailing address

7855 Pine Cone Rd
Colorado Springs, CO 80908-6117
Phone (719) 338-4665

Other identifiers 1

IdentifierTypeStateIssuer
2835OtherCOPSYCHOLOGIST LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170531001129 CO Part B Supplier - Clinic/Group Practice 5698042372 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

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": "1495238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1477080430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 PINE CONE RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809086117",
            "telephone_number": "719-338-4665",
            "fax_number": "719-548-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 PINE CONE RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809086117",
            "telephone_number": "719-338-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER COUNSELING AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-20",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "SOLLY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-338-4665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "2835",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.