Individual provider Active NPI

Debra Jo Landoll, MA, LAC

  • Professional Counselor
  • Grand JCT, CO
National Provider Identifier
1942624630
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0013950 Issued in CO
Practice address
2664 Sacoma CT
Grand JCT, CO 81506-1834
Phone
(970) 261-5254
NPI assigned
Feb 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0000613 CO
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 0013950 CO Primary

Addresses

Primary practice location

2664 Sacoma CT
Grand JCT, CO 81506-1834

Mailing address

2664 Sacoma CT
Grand JCT, CO 81506-1834
Phone (970) 261-5254

Other practice location 1

743 Horizon Ct Ste 343
Grand Jct, CO 81506-8765
Phone (970) 261-5254

Other names 1

  • Debra Jo Gallegos Other name

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
I20240315002354 CO Practitioner - Mental Health Counselor 0648520742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2664 Sacoma CT
Grand JCT, CO 81506-1834
Phone (970) 261-5254

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACD.0000613COMDAddiction (Substance Use Disorder) Counselor
0013950COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Behavioral Therapies Professional CurrentSince Nov 19, 2024 Accepting new patients

Organizations & group practices 1

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": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1942624630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2664 SACOMA CT",
            "city": "GRAND JCT",
            "state": "CO",
            "postal_code": "815061834",
            "telephone_number": "970-261-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2664 SACOMA CT",
            "city": "GRAND JCT",
            "state": "CO",
            "postal_code": "815061834",
            "telephone_number": "970-261-5254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "743 Horizon Ct Ste 343",
            "address_purpose": "LOCATION",
            "city": "Grand Jct",
            "state": "CO",
            "postal_code": "815068765",
            "country_code": "US",
            "telephone_number": "970-261-5254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDOLL",
        "first_name": "DEBRA",
        "middle_name": "JO",
        "credential": "MA, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-14",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0000613",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0013950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "GALLEGOS",
            "middle_name": "JO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand JCT, CO

Sources for this page

Verify at the official NPI Registry.