Individual provider Active NPI

Valerie Susann Medina, LMFT

  • Marriage & Family Therapist
  • Colorado Springs, CO
National Provider Identifier
1992363147
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT.0002559 Issued in CO
Practice address
7932 Bayonet Cir Apt D
Colorado Springs, CO 80902-4693
Phone
(951) 231-7299
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT.0002559 CO Primary
Marriage & Family Therapist 106H00000X 140511 CA

Addresses

Primary practice location

7932 Bayonet Cir Apt D
Colorado Springs, CO 80902-4693

Mailing address

7932 Bayonet Cir Apt D
Colorado Springs, CO 80902-4693
Phone (951) 231-7299

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
I20260504008102 CO Practitioner - Marriage and Family Therapist 0143798538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

731 N Weber St
Suite 215
Colorado Springs, CO 80903-1019

7932 Bayonet Cir
Apt D
Colorado Springs, CO 80902-4693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
140511CAMDMarriage & Family Therapist
MFT.0002559COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Therapy & Coaching PLLC Marriage & Family Therapist CurrentSince Oct 6, 2024 Accepting new patients
Olive Crest Past Accepting new patients

Organizations & group practices 3

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717286400000",
    "number": "1992363147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7932 BAYONET CIR APT D",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809024693",
            "telephone_number": "951-231-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7932 BAYONET CIR APT D",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809024693",
            "telephone_number": "951-231-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "VALERIE",
        "middle_name": "SUSANN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "MFT.0002559",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "140511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.