NPIMap

Organization Active NPI

Crystal Creek Counseling , PC Inc.

  • Professional Counselor
  • Woodland Park, CO
National Provider Identifier
1487113221
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CRYSTAL CREEK COUNSELING , PC INC.
Practice address
400 W Midland Ave Ste 200
Woodland Park, CO 80863-3199
Phone
(719) 686-6703
Fax
(719) 325-8958
NPI assigned
Mar 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Authorized official

Name
Jerilyn L Yingling, LPCNPI 1114343928
Title
Owner
Phone
(719) 686-6703

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

400 W Midland Ave Ste 200
Woodland Park, CO 80863-3199

Mailing address

PO Box 94
Green Mountain Falls, CO 80819-0094
Phone (719) 686-6703

Other practice location 1

500 Coffman St Ste 210
Longmont, CO 80501-5445
Phone (719) 686-6703 ext. 3

National Provider Directory

National Provider Directory
Tax ID family
Crystal Creek Counseling PC Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1487113221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "GREEN MOUNTAIN FALLS",
            "state": "CO",
            "postal_code": "808190094",
            "telephone_number": "719-686-6703",
            "fax_number": "719-325-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MIDLAND AVE STE 200",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808633199",
            "telephone_number": "719-686-6703",
            "fax_number": "719-325-8958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Coffman St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805015445",
            "country_code": "US",
            "telephone_number": "719-686-6703 x3",
            "fax_number": "719-325-8958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CRYSTAL CREEK COUNSELING , PC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "YINGLING",
        "authorized_official_first_name": "JERILYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-686-6703",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.