Individual provider Active NPI

Patrick Herzer, L.M.H.C.A.

  • Mental Health Counselor
  • Lakewood, CO
National Provider Identifier
1679971154
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60448704 Issued in WA
Practice address
13701 W Jewell Ave Ste 205
Lakewood, CO 80228-4180
Phone
(720) 440-2985
Fax
(303) 484-3943
NPI assigned
Dec 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC60448704 WA Primary

Addresses

Primary practice location

13701 W Jewell Ave Ste 205
Lakewood, CO 80228-4180

Mailing address

13701 W Jewell Ave Ste 205
Lakewood, CO 80228-4180
Phone (720) 440-2985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 7, 2024 through Aug 7, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MC60448704WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Home Society of Washington Past Accepting new patients
Cornerstone Christian Counseling, Inc PastSince Jul 3, 2022 Accepting new patients
Cornerstone Christian Counseling, Inc PastSince Jan 24, 2021 Accepting new patients
Children'S Home Society Past Accepting new patients
Cornerstone Christian Counseling, Inc Past Accepting new patients
Cornerstone Christian Counseling, Inc PastSince Dec 18, 2022 Accepting new patients

Organizations & group practices 6

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": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1679971154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13701 W JEWELL AVE STE 205",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802284180",
            "telephone_number": "720-440-2985",
            "fax_number": "303-484-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13701 W JEWELL AVE STE 205",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802284180",
            "telephone_number": "720-440-2985",
            "fax_number": "303-484-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZER",
        "first_name": "PATRICK",
        "credential": "L.M.H.C.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-15",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60448704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.