Individual provider Active NPI

Evguenia Guentcheva, LAC

  • Professional Counselor
  • Canon City, CO
National Provider Identifier
1497882393
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4849 Issued in CO
Practice address
1012 Main St
Canon City, CO 81212-3465
Phone
(719) 406-8073
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 71 CO
Professional Counselor 101YP2500X 4849 CO Primary

Addresses

Primary practice location

1012 Main St
Canon City, CO 81212-3465

Mailing address

503 Candlewood Dr
Canon City, CO 81212-2071
Phone (719) 406-8073

Other names 1

  • Jenni Guentcheva Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4849COMDAddiction (Substance Use Disorder) Counselor
71COMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Goodneighbor Current Accepting new patients
Goodneighbor, LLC Addiction (Substance Use Disorder) Current Accepting new patients

Locations

1012 Main St
Ste A
Canon City, CO 81212

Organizations & group practices 2

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1497882393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CANDLEWOOD DR",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122071",
            "telephone_number": "719-406-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 MAIN ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123465",
            "telephone_number": "719-406-8073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUENTCHEVA",
        "first_name": "EVGUENIA",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "71",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "4849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNI",
            "last_name": "GUENTCHEVA",
            "credential": "LPC, LAC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.