Individual provider Active NPI

Dallas Chismar, LPC

  • Professional Counselor
  • Castle Rock, CO
National Provider Identifier
1609389691
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0014145 Issued in CO
Practice address
333 Perry St Ste 212
Castle Rock, CO 80104-2434
Phone
(719) 216-3866
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0014145 CO Primary

Addresses

Primary practice location

333 Perry St Ste 212
Castle Rock, CO 80104-2434

Mailing address

333 Perry St Ste 212
Castle Rock, CO 80104-2434
Phone (719) 216-3866

Other practice location 1

19751 E Mainstreet Ste R10
Parker, CO 80138-7406
Phone (719) 216-3866

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
I20240520002225 CO Practitioner - Mental Health Counselor 9234571449 Practice locations: Castle Rock, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0014145COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Autumn Consulting, LLC Professional CurrentSince Sep 8, 2024 Accepting new patients
Autumn Consulting, LLC Professional CurrentSince Jun 3, 2025 Accepting new patients

Locations

333 Perry St
Ste 212
Castle Rock, CO 80104
Phone (719) 216-3866

115 Wilcox St
Ste 220
Castle Rock, CO 80104
Phone (303) 881-2936

19751 E Mainstreet
Ste R10
Parker, CO 80138
Phone (719) 216-3866

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": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1609389691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 PERRY ST STE 212",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042434",
            "telephone_number": "719-216-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PERRY ST STE 212",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042434",
            "telephone_number": "719-216-3866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19751 E Mainstreet Ste R10",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801387406",
            "country_code": "US",
            "telephone_number": "719-216-3866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHISMAR",
        "first_name": "DALLAS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0014145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.