Active NPI
Orrin Odell Childers Jr.
- Mental Health Counselor
- Green Mountain Falls, CO
National Provider Identifier
1790995231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 991077
- Practice address
- 10460 W. Highway. 24
Green Mountain Falls, CO 80819 - Phone
- (719) 325-5265
- Fax
- (719) 684-9743
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 991077 | CO | Primary |
Addresses
Primary practice location
10460 W. Highway. 24
Green Mountain Falls, CO 80819
Mailing address
10460 West Highway 24
Green Mountain Falls, CO 80819
Phone (719) 325-5265
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 991077 | CO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790995231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10460 WEST HIGHWAY 24",
"city": "GREEN MOUNTAIN FALLS",
"state": "CO",
"postal_code": "80819",
"telephone_number": "719-325-5265",
"fax_number": "719-684-9743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10460 W. HIGHWAY. 24",
"city": "GREEN MOUNTAIN FALLS",
"state": "CO",
"postal_code": "80819",
"telephone_number": "719-325-5265",
"fax_number": "719-684-9743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDERS",
"first_name": "ORRIN",
"middle_name": "ODELL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "991077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Mountain Falls, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.