Organization Active NPI

Life Compass Counseling LLC

  • Clinical Social Worker
  • Canon City, CO
National Provider Identifier
1750788758
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09923502 Issued in CO
Legal business name
LIFE COMPASS COUNSELING LLC
Practice address
831 Royal Gorge Blvd
Suite 226
Canon City, CO 81212-6709
Phone
(719) 431-9050
NPI assigned
Nov 20, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Jennifer Marie Vanhove, LCSWNPI 1538487053
Title
Owner
Phone
(719) 431-9050

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
Clinical Social Worker 1041C0700X CSW.09923502 CO Primary

Addresses

Primary practice location

831 Royal Gorge Blvd
Suite 226
Canon City, CO 81212-6709

Mailing address

831 Royal Gorge Blvd
Suite 226
Canon City, CO 81212-6709
Phone (719) 431-9050

Other practice location 1

2921 Carlisle Blvd NE Ste 200B
Albuquerque, NM 87110-2868
Phone (505) 916-2131

Other practice location 2

831 Royal Gorge Blvd Ste 226
Canon City, CO 81212-6709
Phone (719) 431-9050

Other identifiers 2

IdentifierTypeStateIssuer
12774090OtherCAQH
16976223MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161201001475 CO Part B Supplier - Clinic/Group Practice 9436439809 Receives reassigned benefits from 1 practitioner
Practice locations: Canon City, CO

National Provider Directory

National Provider Directory

Locations

831 Royal Gorge Blvd
Ste 226
Canon City, CO 81212
Phone (303) 801-8366

2921 Carlisle Blvd NE
Ste 118
Albuquerque, NM 87110
Phone (505) 916-2131

2921 Carlisle Blvd NE
Ste 200B
Albuquerque, NM 87110
Phone (505) 916-2131

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1750788758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 ROYAL GORGE BLVD",
            "address_2": "SUITE 226",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812126709",
            "telephone_number": "719-431-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 ROYAL GORGE BLVD",
            "address_2": "SUITE 226",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812126709",
            "telephone_number": "719-431-9050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2921 Carlisle Blvd NE Ste 200B",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871102868",
            "country_code": "US",
            "telephone_number": "505-916-2131",
            "fax_number": "720-707-0430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "831 Royal Gorge Blvd Ste 226",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "812126709",
            "country_code": "US",
            "telephone_number": "719-431-9050",
            "fax_number": "720-707-0430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE COMPASS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VANHOVE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-431-9050",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12774090",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16976223",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.