Individual provider Active NPI

Beverly Ruth Saller, MA, PSYCHOTHERAPIST

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1790935757
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10172 Issued in CO
Practice address
4585 Hilton Pkwy
Suite 202
Colorado Springs, CO 80907-3569
Phone
(719) 210-9330
Fax
(719) 599-4693
NPI assigned
Sep 26, 2008
Last updated
Sep 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10172 CO Primary

Addresses

Primary practice location

4585 Hilton Pkwy
Suite 202
Colorado Springs, CO 80907-3569

Mailing address

4585 Hilton Pkwy
Suite 202
Colorado Springs, CO 80907-3569
Phone (719) 210-9330

Other identifiers 1

IdentifierTypeStateIssuer
10172OtherCOCOLORADO REGISTRATION (DORA)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
10172COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1790935757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4585 HILTON PKWY",
            "address_2": "SUITE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073569",
            "telephone_number": "719-210-9330",
            "fax_number": "719-599-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 HILTON PKWY",
            "address_2": "SUITE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073569",
            "telephone_number": "719-210-9330",
            "fax_number": "719-599-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLER",
        "first_name": "BEVERLY",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "MA, PSYCHOTHERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "10172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO REGISTRATION (DORA)",
            "identifier": "10172",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.