Active NPI
Nichole Bomar, LPCC
- Mental Health Counselor
- Colorado Springs, CO
National Provider Identifier
1679244545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0018691
- Practice address
- 1465 Kelly Johnson Blvd Ste 305
Colorado Springs, CO 80920-3947 - Phone
- (719) 362-0796
- NPI assigned
- Sep 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0018691 | CO | Primary |
Addresses
Primary practice location
1465 Kelly Johnson Blvd Ste 305
Colorado Springs, CO 80920-3947
Mailing address
2780 Gemini CT
Colorado Springs, CO 80907-8908
Phone (719) 216-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0018691 | CO | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rock Your Family, LLC | Current | Accepting new patients |
Locations
1465 Kelly Johnson Blvd
Ste 305
Colorado Springs, CO 80920
Phone (719) 362-0796
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, 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": "1632182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1679244545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2780 GEMINI CT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809078908",
"telephone_number": "719-216-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 KELLY JOHNSON BLVD STE 305",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809203947",
"telephone_number": "719-362-0796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOMAR",
"first_name": "NICHOLE",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-21",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "0018691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.