Individual provider Active NPI

Chetney Nelsen, LCMFT

  • Marriage & Family Therapist
  • Broomfield, CO
National Provider Identifier
1659314094
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT.0002531 Issued in CO
Practice address
12303 Airport Way Ste 125
Broomfield, CO 80021-2729
Phone
(970) 310-3406
NPI assigned
Jun 14, 2006
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 695 KS
Marriage & Family Therapist 106H00000X MFT.0002531 CO Primary

Addresses

Primary practice location

12303 Airport Way Ste 125
Broomfield, CO 80021-2729

Mailing address

5519 High Meadow Dr
Manhattan, KS 66503-8443
Phone (785) 317-3666

Other identifiers 3

IdentifierTypeStateIssuer
448335OtherKSBCBS NUMBER
11759308OtherCAQH
200437130AMedicaidKS

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
I20240517000838 CO Practitioner - Marriage and Family Therapist 3779924055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heart Centered Counseling PCGroup PAC ID 8628373651, 296 clinicians

Practice addresses (Care Compare)

215 W Oak St
FL 4
Fort Collins, CO 80521-2734
Phone (970) 310-3406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT.0002530COMDMarriage & Family Therapist
MFT.0002531COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Centered Counseling, PC Marriage & Family Therapist CurrentSince Apr 10, 2024 Accepting new patients
Heart Centered Counseling, PC Marriage & Family Therapist CurrentSince Apr 10, 2024 Accepting new patients
Heart Centered Counseling, PC Marriage & Family Therapist Current Accepting new patients

Locations

12303 Airport Way
Ste 125
Broomfield, CO 80021
Phone (253) 346-1331

215 W Oak St
Fl 4
Fort Collins, CO 80521
Phone (253) 346-1331

1770 25th Ave
Ste 206
Greeley, CO 80634
Phone (303) 664-5281

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1659314094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5519 HIGH MEADOW DR",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665038443",
            "telephone_number": "785-317-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 AIRPORT WAY STE 125",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212729",
            "telephone_number": "970-310-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSEN",
        "first_name": "CHETNEY",
        "credential": "LCMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "695",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "MFT.0002531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "448335",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11759308",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200437130A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.