Individual provider Active NPI

Kathryn Bonilla, MA

  • Mental Health Counselor
  • Fort Collins, CO
National Provider Identifier
1922521301
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2629 Redwing Rd Ste 130
Fort Collins, CO 80526-2879
Phone
(970) 404-1220
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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 Primary

Addresses

Primary practice location

2629 Redwing Rd Ste 130
Fort Collins, CO 80526-2879

Mailing address

2629 Redwing Rd Ste 130
Fort Collins, CO 80526-2879
Phone (970) 404-1220

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
I20240422002872 CO Practitioner - Mental Health Counselor 0244679397 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Fort Collins, CO 80524-3929

1107 S Lemay Ave
Suite 100
Fort Collins, CO 80524-3956
Phone (970) 207-4857

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Health Care Inc. Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 29, 2025 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Jan 1, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 29, 2025 Accepting new patients
Integrative Therapies of Co LLC Professional CurrentSince Jan 6, 2026 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

4674 Snow Mesa Dr
Ste 100
Fort Collins, CO 80528
Phone (970) 482-3712

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

4674 Snow Mesa Dr
Ste 200
Fort Collins, CO 80528
Phone (970) 266-3650

2629 Redwing Rd
Ste 130
Fort Collins, CO 80526
Phone (970) 645-3440

1107 S Lemay Ave
Ste 100
Fort Collins, CO 80524
Phone (970) 207-4857

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 6

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": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1922521301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 REDWING RD STE 130",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262879",
            "telephone_number": "970-404-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 REDWING RD STE 130",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262879",
            "telephone_number": "970-404-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "KATHRYN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.