Individual provider Active NPI

Wendy A Harrison

  • Professional Counselor
  • Fort Collins, CO
National Provider Identifier
1780224899
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0020522 Issued in CO
Practice address
4856 Innovation Dr
Fort Collins, CO 80525-5539
Phone
(970) 494-4200
Fax
(970) 613-4475
NPI assigned
Jan 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0002299 CO
Registered Nurse 163W00000X RN.0111647 CO
Professional Counselor 101YP2500X LPC.0020522 CO Primary

Addresses

Primary practice location

4856 Innovation Dr
Fort Collins, CO 80525-5539

Mailing address

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240416004495 CO Practitioner - Mental Health Counselor 1153760632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summitstone Health Partners 116 clinicians

Practice addresses (Care Compare)

1250 N Wilson Ave
Loveland, CO 80537-4461
Phone (970) 494-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD.0002299COMDAddiction (Substance Use Disorder) Counselor
LPC.0020522COMDProfessional Counselor
RN.0111647COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Summitstone Health Partners CurrentSince Jan 31, 2024 Accepting new patients
Summitstone Health Partners Current Accepting new patients
Summitstone Health Partners CurrentSince Jan 31, 2024 Accepting new patients
Summitstone Health Partners Past Accepting new patients
Summitstone Health Partners Past Accepting new patients

Locations

4102 S Timberline Rd
Fort Collins, CO 80525
Phone (970) 494-5728

4856 Innovation Dr
Fort Collins, CO 80525

4856 Innovation Dr
Ste B
Fort Collins, CO 80525
Phone (970) 397-7815

1250 N Wilson Ave
Loveland, CO 80537
Phone (970) 494-9789

Organizations & group practices 5

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": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1780224899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "970-613-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "970-613-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "WENDY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0002299",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0111647",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0020522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.