Organization Active NPI

Solace Healing of Northern Colorado

  • Clinical Social Worker
  • Fort Collins, CO
National Provider Identifier
1861156960
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SOLACE HEALING OF NORTHERN COLORADO
Practice address
109 Coronado CT BLDG 7
Fort Collins, CO 80525-4929
Phone
(970) 599-1205
NPI assigned
Oct 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Authorized official

Name
Jennifer Nicole Leimbach, LCSWNPI 1225608201
Title
Therapist
Phone
(970) 599-1205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

109 Coronado CT BLDG 7
Fort Collins, CO 80525-4929

Mailing address

109 Coronado CT # 7
Fort Collins, CO 80525-4929
Phone (970) 599-1205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220112002018 CO Part B Supplier - Clinic/Group Practice 6608268180 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Collins, CO

National Provider Directory

National Provider Directory

Locations

109 Coronado Ct
#7
Fort Collins, CO 80525
Phone (970) 222-0524

608 E Harmony Rd
Ste 302
Fort Collins, CO 80525
Phone (307) 200-7383

109 Coronado Ct
Bldg 7
Fort Collins, CO 80525
Phone (970) 335-9190

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1861156960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CORONADO CT # 7",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254929",
            "telephone_number": "970-599-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CORONADO CT BLDG 7",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254929",
            "telephone_number": "970-599-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLACE HEALING OF NORTHERN COLORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "LEIMBACH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "970-599-1205",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "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 Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.