NPIMap

Organization Active NPI

Counseling Services of Longmont

  • Addiction (Substance Use Disorder) Counselor
  • Longmont, CO
National Provider Identifier
1609224690
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
178800 Issued in CO
Legal business name
COUNSELING SERVICES OF LONGMONT
Practice address
1129 Francis St
Longmont, CO 80501-3703
Phone
(303) 772-3853
Fax
(303) 772-1718
NPI assigned
May 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Authorized official

Name
Jimmy De HerreraNPI 1598112112
Title
Owner
Phone
(303) 772-3853

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 178800 CO Primary

Addresses

Primary practice location

1129 Francis St
Longmont, CO 80501-3703

Mailing address

1129 Francis St
Longmont, CO 80501-3703
Phone (303) 772-3853

Other identifiers 2

IdentifierTypeStateIssuer
1598112112MedicaidCO
1710104112MedicaidCO

National Provider Directory

National Provider Directory

Locations

1129 Francis St
Longmont, CO 80501
Phone (303) 772-3853

Practitioners & affiliated clinicians

Practitioners 2

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": "1464652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1609224690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 FRANCIS ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013703",
            "telephone_number": "303-772-3853",
            "fax_number": "303-772-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 FRANCIS ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013703",
            "telephone_number": "303-772-3853",
            "fax_number": "303-772-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING SERVICES OF LONGMONT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "DE HERRERA",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-772-3853"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "178800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598112112",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710104112",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.