Individual provider Active NPI

Rae Carnevale

  • Professional Counselor
  • Pueblo, CO
National Provider Identifier
1487136396
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0019569 Issued in CO
Practice address
1304 Chinook LN
Pueblo, CO 81001-1851
Phone
(719) 545-2746
Fax
(719) 542-9638
NPI assigned
Sep 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X LPC.0019569 CO Primary

Addresses

Primary practice location

1304 Chinook LN
Pueblo, CO 81001-1851

Mailing address

41 Montebello Rd Ste 204
Pueblo, CO 81001-1379
Phone (719) 545-2746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20231228002999 CO Practitioner - Mental Health Counselor 3779933064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0019569COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Health Solutions CurrentSince Jan 1, 2024 Accepting new patients
Health Solutions CurrentSince Jan 1, 2024 Accepting new patients
Health Solutions Past Accepting new patients
Spanish Peaks New Alternatives, Inc. Past Accepting new patients

Locations

1302 Chinook Ln
Pueblo, CO 81001

41 Montebello Rd
Ste 204
Pueblo, CO 81001
Phone (719) 423-1341

2003 E 4th St
Pueblo, CO 81001
Phone (719) 544-6373

41 Montebello Rd
Lowr LL1
Pueblo, CO 81001

41 Montebello Rd
Ste 202
Pueblo, CO 81001
Phone (719) 423-1341

1304 Chinook Ln
Pueblo, CO 81001
Phone (719) 562-3222

1012 W Abriendo Ave
Pueblo, CO 81004
Phone (719) 583-2207

1310 Chinook Ln
Pueblo, CO 81001

41 Montebello Rd
Ste 116
Pueblo, CO 81001
Phone (719) 423-1500

41 Montebello Rd
Ste 104
Pueblo, CO 81001

41 Montebello Rd
Ste 100
Pueblo, CO 81001

910 E Main St
Trinidad, CO 81082
Phone (719) 631-3370

417 S Indiana Ave
Trinidad, CO 81082
Phone (719) 846-4416

926 Russell Ave
Walsenburg, CO 81089
Phone (719) 738-2386

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1487136396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD STE 204",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011379",
            "telephone_number": "719-545-2746",
            "fax_number": "719-545-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 CHINOOK LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011851",
            "telephone_number": "719-545-2746",
            "fax_number": "719-542-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEVALE",
        "first_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0019569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.