NPIMap

Organization Active NPI

Polaris Partners Counseling and Consulting LLC

  • Clinical Social Worker
  • Fort Morgan, CO
National Provider Identifier
1801512140
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
POLARIS PARTNERS COUNSELING AND CONSULTING LLC
Practice address
411 Main St Ste 204
Fort Morgan, CO 80701-2141
Phone
(866) 285-2929
Fax
(208) 567-5844
NPI assigned
Oct 18, 2022
Last updated
Nov 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Damond Dotson, PHD, LMFTNPI 1437375730
Title
Co-Owner
Phone
(970) 576-1717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

411 Main St Ste 204
Fort Morgan, CO 80701-2141

Mailing address

155 S Madison St Ste 306
Denver, CO 80209-3014
Phone (970) 576-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201105002183 CO Part B Supplier - Clinic/Group Practice 2769892538 Receives reassigned benefits from 21 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Collins, CO; Parker, CO; Fort Morgan, CO; Denver, CO

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Polaris Partners Counseling and Consulting LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2850 McClelland Dr
Ste 3400
Fort Collins, CO 80525
Phone (303) 345-8004

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1801512140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S MADISON ST STE 306",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093014",
            "telephone_number": "970-576-1717",
            "fax_number": "208-567-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MAIN ST STE 204",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807012141",
            "telephone_number": "866-285-2929",
            "fax_number": "208-567-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS PARTNERS COUNSELING AND CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "DOTSON",
        "authorized_official_first_name": "DAMOND",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "970-576-1717",
        "authorized_official_credential": "PHD, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Morgan, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.