Individual provider Active NPI

Jose Luis Tapia-Fuselier Jr., PHD, CRC, LPC, NCC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1760962955
Registry record updated Oct 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0017322 Issued in CO
Practice address
1283 Kelly Johnson Blvd
Colorado Springs, CO 80920-3925
Phone
(719) 413-6776
NPI assigned
Aug 16, 2018
Last updated
Oct 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0017322 CO Primary

Addresses

Primary practice location

1283 Kelly Johnson Blvd
Colorado Springs, CO 80920-3925

Mailing address

1283 Kelly Johnson Blvd
Colorado Springs, CO 80920-3925
Phone (719) 413-6776

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522001926 CO Practitioner - Mental Health Counselor 0143662148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurofeedback Colorado Springs IncGroup PAC ID 0446660575, 6 clinicians

Practice addresses (Care Compare)

1283 Kelly Johnson Blvd
Suite 200
Colorado Springs, CO 80920-3925
Phone (719) 639-2928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0017322COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vanda Counseling Collaborative Professional Current Accepting new patients
Neurofeedback Colorado Springs, Inc. Mental Health CurrentSince Apr 7, 2024 Accepting new patients
Neurofeedback Colorado Springs, Inc. Mental Health PastSince Apr 7, 2024 Accepting new patients

Locations

1283 Kelly Johnson Blvd
Colorado Springs, CO 80920
Phone (719) 413-6776

1283 Kelly Johnson Blvd
Ste 200
Colorado Springs, CO 80920
Phone (719) 413-6776

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633737600000",
    "number": "1760962955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1283 KELLY JOHNSON BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203925",
            "telephone_number": "719-413-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 KELLY JOHNSON BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203925",
            "telephone_number": "719-413-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPIA-FUSELIER",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD, CRC, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-16",
        "last_updated": "2021-10-09",
        "certification_date": "2021-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0017322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.