Individual provider Active NPI

Judith M Leibovitz, MS, ATR, LPC

  • Mental Health Counselor
  • Longmont, CO
National Provider Identifier
1558128181
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0020401 Issued in CO
Practice address
500 Kimbark St Ste 200
Longmont, CO 80501-5585
Phone
(303) 651-1515
NPI assigned
Feb 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0020401 CO Primary

Addresses

Primary practice location

500 Kimbark St Ste 200
Longmont, CO 80501-5585

Mailing address

4086 Greenbriar Blvd
Boulder, CO 80305-7047
Phone (414) 517-3999

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
I20260416002947 CO Practitioner - Clinical Social Worker 1658847702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

155 S Coopers Hawk Way
Palm Coast, FL 32164-2359

500 Kimbark St
Suite 200
Longmont, CO 80501-5585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0020401COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Krupnick Counseling Associates PC CurrentSince Mar 3, 2024 Accepting new patients

Locations

500 Kimbark St
Ste 200
Longmont, CO 80501
Phone (303) 651-1515

Organizations & group practices 1

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1558128181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4086 GREENBRIAR BLVD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803057047",
            "telephone_number": "414-517-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 KIMBARK ST STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805015585",
            "telephone_number": "303-651-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOVITZ",
        "first_name": "JUDITH",
        "middle_name": "M",
        "credential": "MS, ATR, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "0020401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.