Active NPI
Brandon J Roth, LPC
- Professional Counselor
- Fort Collins, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC.0018181
- Practice address
- 306 Bowline CT
Fort Collins, CO 80525-3116 - Phone
- (208) 317-5875
- NPI assigned
- May 3, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC.0018181 | CO | Primary |
Addresses
Primary practice location
306 Bowline CT
Fort Collins, CO 80525-3116
Mailing address
306 Bowline CT
Fort Collins, CO 80525-3116
Phone (208) 317-5875
Other practice location 1
4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone (970) 494-4200
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC.0018181 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ba Counseling, Consultation and Education | Professional | Current | Accepting new patients |
| Summitstone Health Partners | Current | Accepting new patients | |
| Ba Counseling, Consultation and Education | Current | Accepting new patients | |
| Summitstone Health Partners | Current | Accepting new patients | |
| Summitstone Health Partners | Current | Accepting new patients | |
| Longview Behavioral Health | Past | Accepting new patients | |
| Summitstone Health Partners | Past | Accepting new patients | |
| Longview Behavioral Health | Professional | Past | Accepting new patients |
| Longview Behavioral Health | Past | Accepting new patients | |
| Longview Behavioral Health | Past | Accepting new patients | |
| Summitstone Health Partners | Past | Accepting new patients |
Locations
4102 S Timberline Rd
Fort Collins, CO 80525
Phone (970) 494-5728
2627 Redwing Rd
Ste 325
Fort Collins, CO 80526
Phone (303) 435-3828
4856 Innovation Dr
Fort Collins, CO 80525
1250 N Wilson Ave
Loveland, CO 80537
Phone (970) 494-9789
8471 Turnpike Dr
Ste 220
Westminster, CO 80031
Phone (719) 588-1635
Organizations & group practices 11
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.
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-
- Professional Counselor
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- NPI 1558132761
-
- Adult Mental Health Clinic/Center
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- NPI 1154135861
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
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- NPI 1427383678
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fort Collins, CO
- NPI 1164269809
-
- Clinical Medical Laboratory
- Fort Collins, CO
- NPI 1194572545
-
- Professional Counselor
- Fort Collins, CO
- NPI 1700567096
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Fort Collins, CO
- NPI 1992486278
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fort Collins, CO
- NPI 1023799301
-
- Community/Retail Pharmacy
- Fort Collins, CO
- NPI 1730935222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1740925833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 BOWLINE CT",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805253116",
"telephone_number": "208-317-5875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 BOWLINE CT",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805253116",
"telephone_number": "208-317-5875"
}
],
"practiceLocations": [
{
"address_1": "4856 Innovation Dr",
"address_purpose": "LOCATION",
"city": "Fort Collins",
"state": "CO",
"postal_code": "805255539",
"country_code": "US",
"telephone_number": "970-494-4200",
"fax_number": "844-270-1824",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROTH",
"first_name": "BRANDON",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-03",
"last_updated": "2025-03-26",
"certification_date": "2025-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPC.0018181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.