Individual provider Active NPI

Amber W. Pearson, MA, LPC

  • Professional Counselor
  • Broomfield, CO
National Provider Identifier
1992056246
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-6479 Issued in CO
Practice address
11001 W 120TH Ave Ste 400
Broomfield, CO 80021-3493
Phone
(720) 644-6378
Fax
(720) 446-3520
NPI assigned
Sep 26, 2012
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
Professional Counselor 101YP2500X LPC-6479 CO Primary

Addresses

Primary practice location

11001 W 120TH Ave Ste 400
Broomfield, CO 80021-3493

Mailing address

PO Box 155
Broomfield, CO 80038-0155
Phone (720) 644-6378

Other identifiers 1

IdentifierTypeStateIssuer
40876870MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC-6479COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wellness and Strategies, LLC Professional PastSince Jul 24, 2022 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": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992056246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800380155",
            "telephone_number": "720-644-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 W 120TH AVE STE 400",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213493",
            "telephone_number": "720-644-6378",
            "fax_number": "720-446-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "AMBER",
        "middle_name": "W.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC-6479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40876870",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.