Active NPI
John Vanderscoff Eisen, LPC
- Addiction (Substance Use Disorder) Counselor
- Denver, CO
National Provider Identifier
1679615066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 3819
- Practice address
- 2111 Champa St
Denver, CO 80205-2529 - Phone
- (303) 568-9231
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH6106 | FL | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3819 | CO | Primary |
Addresses
Primary practice location
2111 Champa St
Denver, CO 80205-2529
Mailing address
2111 Champa St
Denver, CO 80205-2529
Phone (303) 312-9601
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 |
|---|---|---|---|
| 3819 | CO | MD | Addiction (Substance Use Disorder) Counselor |
| MH6106 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595203200000",
"number": "1679615066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 CHAMPA ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802052529",
"telephone_number": "303-312-9601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2111 CHAMPA ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802052529",
"telephone_number": "303-568-9231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISEN",
"first_name": "JOHN",
"middle_name": "VANDERSCOFF",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2020-07-20",
"certification_date": "2020-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH6106",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "3819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.