Antlers Creek Counseling Center, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09923654 Issued in CO

Legal business name

ANTLERS CREEK COUNSELING CENTER, PLLC

Practice address

12106 Rio Secco Rd
Peyton, CO 80831-4032

Phone

(719) 220-8662

NPI assigned

Sep 10, 2018

Last updated

Feb 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Renee M Martinez-Epperson, LCSW, CACIINPI 1851872527

Title

Licensed Clinical Social Worker

Phone

(719) 394-8797

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 1

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.

• Renee Michelle Martinez-Epperson, MSW, LCSW, CAC II

  • Clinical Social Worker
  • Peyton, CO
  • NPI 1851872527
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1851874515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12106 RIO SECCO RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314032",
            "telephone_number": "719-394-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12106 RIO SECCO RD",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314032",
            "telephone_number": "719-220-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTLERS CREEK COUNSELING CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-10",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ-EPPERSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "719-394-8797",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW, CACII"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1911930832",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terran Lynn Allen, MS, CCC-SLP
• Elfreda Amay
• Emmanuel Amay
• Ashley Ammons
• Alerick Ernest Anthony
• Shannon Roisin Baird, PA-C
• Randal F Bales, BA/ATC
• Breanna June Ballard
• Andrea Barrett
• Michelle Benvenuto

• Clinical Social Worker in Peyton, CO
• Providers in Peyton, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.