Individual provider Active NPI

Clinton E Nicholson, MA, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1770079816
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0016143 Issued in CO
Practice address
1259 Lake Plaza Dr Ste 200
Colorado Springs, CO 80906-3516
Phone
(719) 622-6522
Fax
(719) 622-6520
NPI assigned
Jul 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0001759
Professional Counselor 101YP2500X 0016143 CO Primary

Addresses

Primary practice location

1259 Lake Plaza Dr Ste 200
Colorado Springs, CO 80906-3516

Mailing address

1840 Woodmoor Dr Ste 102
Monument, CO 80132-9083
Phone (719) 622-6522

Other practice location 1

1840 Woodmoor Dr Ste 102
Monument, CO 80132-9083
Phone (719) 622-6522

Other practice location 2

8580 Scarborough Dr Ste 125
Colorado Springs, CO 80920-7584
Phone (719) 622-6522

Other practice location 3

1295 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3978
Phone (719) 622-6522

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
I20240605002399 CO Practitioner - Mental Health Counselor 7315489390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Recovery TMS, LLCGroup PAC ID 2163822511, 9 clinicians

Practice addresses (Care Compare)

1259 Lake Plaza Dr
Suite 200
Colorado Springs, CO 80906-3516
Phone (719) 622-6522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Recovery TMS, LLC CurrentSince Apr 28, 2024 Accepting new patients

Locations

8580 Scarborough Dr
Ste 125
Colorado Springs, CO 80920
Phone (719) 282-1211

1295 Kelly Johnson Blvd
Ste 100
Colorado Springs, CO 80920
Phone (719) 622-6522

1259 Lake Plaza Dr
Ste 200
Colorado Springs, CO 80906
Phone (719) 622-6522

1840 Woodmoor Dr
Ste 102
Monument, CO 80132
Phone (719) 622-6522

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1770079816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 WOODMOOR DR STE 102",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801329083",
            "telephone_number": "719-622-6522",
            "fax_number": "719-622-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 LAKE PLAZA DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063516",
            "telephone_number": "719-622-6522",
            "fax_number": "719-622-6520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Woodmoor Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Monument",
            "state": "CO",
            "postal_code": "801329083",
            "country_code": "US",
            "telephone_number": "719-622-6522",
            "fax_number": "719-622-6520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8580 Scarborough Dr Ste 125",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809207584",
            "country_code": "US",
            "telephone_number": "719-622-6522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1295 Kelly Johnson Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809203978",
            "country_code": "US",
            "telephone_number": "719-622-6522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CLINTON",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "0001759",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0016143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.