Individual provider Active NPI

Samantha Perez, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1669286167
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0021831 Issued in CO
Practice address
1259 Lake Plaza Dr Ste 255
Colorado Springs, CO 80906-3542
Phone
(917) 921-0369
NPI assigned
Feb 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 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 LPC.0021831 CO Primary

Addresses

Primary practice location

1259 Lake Plaza Dr Ste 255
Colorado Springs, CO 80906-3542

Mailing address

1120 Trek Trail HTS Apt 204
Colorado Springs, CO 80921-4515
Phone (917) 921-0369

Other practice location 1

1120 Trek Trail Hts Apt 204
Colorado Springs, CO 80921-4515
Phone (917) 921-0369

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
I20250321000420 CO Practitioner - Mental Health Counselor 5193247971 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pickett Psychological Services, LLC CurrentSince Jan 24, 2025 Accepting new patients
Pickett Psychological Services, LLC CurrentSince Jan 24, 2025 Accepting new patients
Nalin J Mehta MD PC PastSince Aug 15, 2003 Accepting new patients

Locations

1259 Lake Plaza Dr
Ste 255
Colorado Springs, CO 80906
Phone (719) 598-3585

274 Union Blvd
Ste 120
Lakewood, CO 80228
Phone (303) 893-5138

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1669286167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 TREK TRAIL HTS APT 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809214515",
            "telephone_number": "917-921-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 LAKE PLAZA DR STE 255",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063542",
            "telephone_number": "917-921-0369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 Trek Trail Hts Apt 204",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809214515",
            "country_code": "US",
            "telephone_number": "917-921-0369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "SAMANTHA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0021831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.