Individual provider Active NPI

Jeremy Robert Allen, LPC

  • Mental Health Counselor
  • Wheat Ridge, CO
National Provider Identifier
1558768747
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC15069 Issued in CO
Practice address
5181 Ward Rd
Ste 206
Wheat Ridge, CO 80033-1925
Phone
(720) 724-6813
Fax
(720) 828-6114
NPI assigned
Dec 3, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X WA61181852 WA
Mental Health Counselor 101YM0800X LPC15069 CO Primary

Addresses

Primary practice location

5181 Ward Rd
Ste 206
Wheat Ridge, CO 80033-1925

Mailing address

5181 Ward Rd
Ste 206
Wheat Ridge, CO 80033-1925
Phone (720) 724-6813

Other practice location 1

4301 S Pine St Ste 17
Tacoma, WA 98409-7252
Phone (253) 313-2438

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
I20240409004131 CO Practitioner - Mental Health Counselor 5395183313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5181 Ward Rd
Unit 206
Wheat Ridge, CO 80033-1925
Phone (720) 724-6813

5181 Ward Rd Unit
Suite 206
Wheat Ridge, CO 80033-1925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC15069COMDMental Health Counselor
WA61181852WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Front Range Family Resource Center LLC Mental Health CurrentSince Mar 1, 2024 Accepting new patients
Emerald Isle Health and Wellness CurrentSince Mar 13, 2022 Accepting new patients

Locations

5181 Ward Rd
Unit 201
Wheat Ridge, CO 80033
Phone (303) 520-7300

5181 Ward Rd
Unit 206
Wheat Ridge, CO 80033
Phone (720) 315-0123

4301 S Pine St
Ste 17
Tacoma, WA 98409
Phone (253) 313-2438

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": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1558768747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5181 WARD RD",
            "address_2": "STE 206",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800331925",
            "telephone_number": "720-724-6813",
            "fax_number": "720-828-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5181 WARD RD",
            "address_2": "STE 206",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800331925",
            "telephone_number": "720-724-6813",
            "fax_number": "720-828-6114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 S Pine St Ste 17",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984097252",
            "country_code": "US",
            "telephone_number": "253-313-2438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JEREMY",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-03",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "WA61181852",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC15069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.