Individual provider Active NPI

Dianna Lee Cordero, LPC

  • Mental Health Counselor
  • Wheat Ridge, CO
National Provider Identifier
1962920918
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC.0013702 Issued in CO
Practice address
4931 Garrison St.
Apt 104
Wheat Ridge, CO 80033
Phone
(252) 414-0511
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 LPC.0013702 CO Primary

Addresses

Primary practice location

4931 Garrison St.
Apt 104
Wheat Ridge, CO 80033

Mailing address

4931 Garrison St Apt 104
Wheat Ridge, CO 80033-6700
Phone (252) 414-0511

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
I20240208004702 CO Practitioner - Mental Health Counselor 3375986029 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
Group practices
Queer AsteriskGroup PAC ID 1153750146, 3 clinicians

Practice addresses (Care Compare)

1200 Yarmouth Ave
Unit C
Boulder, CO 80304-4803
Phone (720) 507-6161

1575 N Franklin St
Denver, CO 80218-1624
Phone (720) 507-6161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Queer Asterisk Mental Health CurrentSince Dec 26, 2023 Accepting new patients
Queer Asterisk Mental Health Past Accepting new patients

Locations

1200 Yarmouth Ave
Unit B
Boulder, CO 80304
Phone (303) 786-9314

1575 N Franklin St
Denver, CO 80218
Phone (303) 253-2187

Organizations & group practices 2

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": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962920918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4931 GARRISON ST APT 104",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336700",
            "telephone_number": "252-414-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4931 GARRISON ST.",
            "address_2": "APT 104",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "80033",
            "telephone_number": "252-414-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO",
        "first_name": "DIANNA",
        "middle_name": "LEE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0013702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.