Mary Lee Churchill, LPC.0016945

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0016945 Issued in CO

Practice address

2860 S Circle Dr Ste 103
Colorado Springs, CO 80906-4113

Phone

(719) 297-7646

NPI assigned

May 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1790141984
  Medicare reassignment Care Compare group NPD
• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288

  Professional

  NPD

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1720724909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 103B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064113",
            "telephone_number": "719-540-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S CIRCLE DR STE 103",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064113",
            "telephone_number": "719-297-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "MARY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LPC.0016945",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0016945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Allen Chupka, PHARMD
• Kelly Ann Chupka, RPH
• Clare Chura, OTR/L
• Bryce Donald Church, DMD
• Samantha Church
• Kartiki Unmesh Churi, M.D.
• Melanie Cecile Churinetz, DDS
• Philip Burns Ciborowski, DDS
• Meagan Ciccolini
• William John Ciccone, M.D.

• Professional Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.