NPIMap

Organization Active NPI

Open Gate Counseling Service, LLC

  • Professional Counselor
  • Pueblo, CO
National Provider Identifier
1700612892
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
OPEN GATE COUNSELING SERVICE, LLC
Practice address
2701 California St
Pueblo, CO 81004-3869
Phone
(888) 948-6789
Fax
(877) 345-3501
NPI assigned
Sep 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Karen C Khaton, LPCNPI 1932524394
Title
Owner
Phone
(719) 744-2326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

2701 California St
Pueblo, CO 81004-3869

Mailing address

1 Kalisa Way Ste 101
Paramus, NJ 07652-3508
Phone (888) 948-6789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241211000524 CO Part B Supplier - Clinic/Group Practice 2860928009 Receives reassigned benefits from 1 practitioner
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pueblo, CO

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Open Gate Counseling Service LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1700612892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KALISA WAY STE 101",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523508",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CALIFORNIA ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043869",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN GATE COUNSELING SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "KHATON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-744-2326",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.