Individual provider Active NPI

Morrisa Vandyke, MA, LPC

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1912365859
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6093 Issued in CO
Practice address
2542 E Bijou St
Colorado Springs, CO 80909-6013
Phone
(719) 301-6882
NPI assigned
Feb 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6093 CO Primary

Addresses

Primary practice location

2542 E Bijou St
Colorado Springs, CO 80909-6013

Mailing address

2542 E Bijou St
Colorado Springs, CO 80909-6013
Phone (719) 649-9922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105003912 CO Practitioner - Mental Health Counselor 6901257765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Achieve Whole Recovery, PCGroup PAC ID 8123388527, 23 clinicians

Practice addresses (Care Compare)

1115 Elkton Dr
Suite 300
Colorado Springs, CO 80907-3597
Phone (719) 373-9703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6093COMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Whole Recovery PC CurrentSince Jan 1, 2024 Accepting new patients
Achieve Whole Recovery, PC CurrentSince Jan 1, 2024 Accepting new patients
Achieve Whole Recovery, PC Current Accepting new patients
Stepping Stones Counseling Service Past Accepting new patients

Locations

1115 Elkton Dr
Ste 300
Colorado Springs, CO 80907
Phone (719) 357-6471

1905 N Sherman St
Ste 900
Denver, CO 80203
Phone (303) 749-5150

8380 Zuni St
Ste 305
Westminster, CO 80221
Phone (719) 357-6471

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1912365859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 E BIJOU ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096013",
            "telephone_number": "719-649-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 E BIJOU ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096013",
            "telephone_number": "719-301-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "MORRISA",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-07",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "6093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.