Individual provider Active NPI

Kelli Hubbard

  • Professional Counselor
  • Denver, CO
National Provider Identifier
1780346296
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0015161
Practice address
3401 Eudora St
Denver, CO 80207-2500
Phone
(303) 504-6500
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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 0001736
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 0015161 Primary

Addresses

Primary practice location

3401 Eudora St
Denver, CO 80207-2500

Mailing address

4141 E Dickenson PL
Denver, CO 80222-6012

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
I20231205003025 CO Practitioner - Mental Health Counselor 1951750769 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of Denver CurrentSince Jan 1, 2024 Accepting new patients
Mental Health Center of Denver Current Accepting new patients
Mental Health Center of Denver CurrentSince Jan 1, 2024 Accepting new patients
Family Life Counseling, P.C. Professional Past Accepting new patients

Locations

4141 E Dickenson Pl
Denver, CO 80222
Phone (303) 504-6509

3401 Eudora St
Denver, CO 80207
Phone (303) 300-6266

Organizations & group practices 4

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": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1780346296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 E DICKENSON PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 EUDORA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072500",
            "telephone_number": "303-504-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "0001736",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "0015161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.