Individual provider Active NPI

Kevin Cherry Jr., LPC

  • Professional Counselor
  • Lone Tree, CO
National Provider Identifier
1619367653
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0012034 Issued in CO
Practice address
9220 Teddy LN Ste 2000a
Lone Tree, CO 80124-6740
Phone
(720) 295-7305
Fax
(720) 770-7266
NPI assigned
Jan 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 0000812 CO
Professional Counselor 101YP2500X 0012034 CO Primary

Addresses

Primary practice location

9220 Teddy LN Ste 2000a
Lone Tree, CO 80124-6740

Mailing address

9220 Teddy LN Ste 2000a
Lone Tree, CO 80124-6740
Phone (720) 295-7304

Other practice location 1

4386 Trail Boss Dr
Castle Rock, CO 80104-7512
Phone (720) 295-7304

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
I20250730001646 CO Practitioner - Mental Health Counselor 3779090584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000812COMDAddiction (Substance Use Disorder) Counselor
0012034COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry and Cherry Counseling LLC Addiction (Substance Use Disorder) CurrentSince May 10, 2025 Accepting new patients

Locations

9220 Teddy Ln
Ste 2000A
Lone Tree, CO 80124
Phone (720) 295-7304

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": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1619367653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 TEDDY LN STE 2000A",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801246740",
            "telephone_number": "720-295-7304",
            "fax_number": "720-770-7266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 TEDDY LN STE 2000A",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801246740",
            "telephone_number": "720-295-7305",
            "fax_number": "720-770-7266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4386 Trail Boss Dr",
            "address_purpose": "LOCATION",
            "city": "Castle Rock",
            "state": "CO",
            "postal_code": "801047512",
            "country_code": "US",
            "telephone_number": "720-295-7304",
            "fax_number": "720-770-7266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "KEVIN",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-29",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "0000812",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0012034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.