Individual provider Active NPI

Matthew Mottram

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1902737430
Registry record updated May 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0021657 Issued in CO
Practice address
4863 N Nevada Ave
Colorado Springs, CO 80918-3951
Phone
(719) 229-0381
NPI assigned
May 25, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2026

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 0021657 CO Primary

Addresses

Primary practice location

4863 N Nevada Ave
Colorado Springs, CO 80918-3951

Mailing address

5325 Evening Light CT
5325 Evening Light CT
Colorado Springs, CO 80917-1056
Phone (719) 229-0381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0021657COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1779667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1902737430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 EVENING LIGHT CT",
            "address_2": "5325 EVENING LIGHT CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809171056",
            "telephone_number": "719-229-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4863 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183951",
            "telephone_number": "719-229-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTRAM",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-25",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "0021657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.