NPIMap

Organization Active NPI

Neurofeedback Clinic of Northern Colorado LLC

  • Marriage & Family Therapist
  • Greeley, CO
National Provider Identifier
1760043897
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC
Practice address
8203 W 20TH St
Greeley, CO 80634-4696
Phone
(970) 673-8103
NPI assigned
Jun 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Lisa PendletonNPI 1548591878
Title
Owner
Phone
(970) 217-9411

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
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

8203 W 20TH St
Greeley, CO 80634-4696

Mailing address

8203 W 20TH St
Greeley, CO 80634-4696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150909000093 CO Part B Supplier - Clinic/Group Practice 6406162353 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Collins, CO; Greeley, CO

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Neurofeedback Clinic of Northern Colorado LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

8203 W 20th St
Greeley, CO 80634
Phone (970) 673-8103

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1760043897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8203 W 20TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8203 W 20TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344696",
            "telephone_number": "970-673-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROFEEDBACK CLINIC OF NORTHERN COLORADO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-28",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "PENDLETON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-217-9411"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.