NPIMap

Organization Active NPI

Polaris Partners Counseling and Consulting LLC

  • Professional Counselor
  • Fort Collins, CO
National Provider Identifier
1912764515
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
POLARIS PARTNERS COUNSELING AND CONSULTING LLC
Practice address
3003 E Harmony Rd Ste 120
Fort Collins, CO 80528-9625
Phone
(866) 285-2929
Fax
(208) 567-5844
NPI assigned
Mar 1, 2024
Last updated
Mar 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
POLARIS PARTNERS COUNSELING AND CONSULTING LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Authorized official

Name
Damond Dotson, PHD, LFMTNPI 1437375730
Title
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

3003 E Harmony Rd Ste 120
Fort Collins, CO 80528-9625

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
Part of
Polaris Partners Counseling and Consulting LLC

Other organizations with this tax ID 10

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

Locations

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

3003 E Harmony Rd
Ste 120
Fort Collins, CO 80528
Phone (970) 294-3088

Practitioners & affiliated clinicians

Practitioners 3

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": "1709251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1912764515",
    "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": "3003 E HARMONY RD STE 120",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805289625",
            "telephone_number": "866-285-2929",
            "fax_number": "208-567-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS PARTNERS COUNSELING AND CONSULTING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POLARIS PARTNERS COUNSELING AND CONSULTING LLC",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "DOTSON",
        "authorized_official_first_name": "DAMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-576-1717",
        "authorized_official_credential": "PHD, LFMT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "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 Mar 1, 2024; 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.