Individual provider Active NPI

Stephen P Street, LPC

  • Professional Counselor
  • Greeley, CO
National Provider Identifier
1992040307
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12487 Issued in CO
Practice address
1300 N 17TH Ave
Greeley, CO 80631-9584
Phone
(970) 347-2120
Fax
(970) 346-9800
NPI assigned
Dec 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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 12487 CO Primary

Addresses

Primary practice location

1300 N 17TH Ave
Greeley, CO 80631-9584

Mailing address

1300 N 17TH Ave
Greeley, CO 80631-9584
Phone (970) 347-2120

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
I20240401002492 CO Practitioner - Mental Health Counselor 5698110096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4665 W 20TH St
Unit C1
Greeley, CO 80634-3221
Phone (970) 405-3438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12487COMDProfessional Counselor

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": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1992040307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "970-347-2120",
            "fax_number": "970-346-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "970-347-2120",
            "fax_number": "970-346-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "12487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.