Individual provider Active NPI

Janice Hauser Schultz, PSYD, LPC

  • Professional Counselor
  • Pueblo, CO
National Provider Identifier
1659443216
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1421 Issued in CO
Practice address
720 N Main St Ste 240
Pueblo, CO 81003-3046
Phone
(719) 250-5888
Fax
(855) 775-0361
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X
Professional Counselor 101YP2500X 1421 CO Primary

Addresses

Primary practice location

720 N Main St Ste 240
Pueblo, CO 81003-3046

Mailing address

1507 Wabash Ave
Pueblo, CO 81004-3345
Phone (719) 250-5888

Other identifiers 2

IdentifierTypeStateIssuer
9000149674MedicaidCO
068103MedicaidCO

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
I20240119003982 CO Practitioner - Mental Health Counselor 4789036286 Reassigns benefits to 1 organization
Practice locations: Pueblo, CO

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

720 N Main St
Suite 240
Pueblo, CO 81003-3046
Phone (719) 250-5888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1421COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Schultz Dental Office LLC CurrentSince Mar 12, 2024 Accepting new patients
Deer Oaks West LLC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

5822 S Lowell Way
Littleton, CO 80123
Phone (303) 798-2497

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1659443216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 WABASH AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043345",
            "telephone_number": "719-250-5888",
            "fax_number": "855-775-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N MAIN ST STE 240",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033046",
            "telephone_number": "719-250-5888",
            "fax_number": "855-775-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "JANICE",
        "middle_name": "HAUSER",
        "name_prefix": "Dr.",
        "credential": "PSYD, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-03-04",
        "certification_date": "2022-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "1421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000149674",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068103",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.