MENTAL FITNESS COLORADO, LLC (NPI# 1538673553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538673553 |
| Entity Type | Organization |
| Organization Name | MENTAL FITNESS COLORADO, LLC |
| Practice Address |
2627 Redwing Rd Ste 220 Fort Collins CO 80526-6331 |
| Practice Telephone | 9706824353 |
| Practice Fax Number | 9705303839 |
| Mailing Telephone | 9706824353 |
| Mailing Fax Number | 9705303839 |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |
| Authorized Official Name | ADAM R MUSGRAVE (OWNER) |
| Authorized Official Telephone | 9706824353 |
| Authorized Official Credential | PA-C, PSYCHIATRY |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
20171759951 | CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPPES - NPI | 1417043837 | 01 |
| Street Address |
2627 REDWING RD STE 220 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80526-6331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417043837 | Adam Richard Musgrave | Physician Assistant | 2627 Redwing Rd Ste 220, Fort Collins, CO 80526-6331 | 2006-10-04 |
| 1467740712 | Deborah Gentry | Social Worker | 2627 Redwing Rd Ste 220, Fort Collins, CO 80526-6331 | 2011-07-20 |
| 1972775732 | Tamara Lee Boyer | Social Worker | 2627 Redwing Rd Ste 220, Fort Collins, CO 80526-6331 | 2008-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831736057 | Jade Elaine Tilley | Behavior Technician | 3005 Ross Drive Apt V #21, Fort Collins, CO 80526 | 2019-12-06 |
| 1073179131 | Jana Marie Carson | Marriage & Family Therapist | 2001 S. Shields St. Bld K, Ft. Collins, CO 80526 | 2019-05-14 |
| 1467922443 | Marshall Hannum | Occupational Therapist | 2312 Limousin Ct., Fort Collins, CO 80526 | 2018-12-03 |
| 1205326634 | Marlene A Baczek | Acupuncturist | 2001 S. Shields, Bldg B, Ste 2, Fort Collins, CO 80526 | 2018-05-10 |
| 1164922852 | James Joseph Reid | Social Worker | 831 Benthaven St., Ft. Collins, CO 80526 | 2018-02-19 |
| 1982113718 | Friends of L'arche Fort Collins | Community/Behavioral Health | 4500 Seneca St Unit 71, Fort Collins, CO 80526 | 2017-09-25 |
| 1578004313 | Jenessa Dyke | Chiropractor | 2531 S Shields St # 2j-h, Fort Collins, CO 80526 | 2017-03-13 |
| 1588102388 | Sarah Klein | Counselor | 1301 Glen Haven Dr, Fort Collins, CO 80526 | 2017-02-01 |
| 1972046530 | Benu Amun-ra | Non-emergency Medical Transport (VAN) | 4779 Skyline Dr, Ft. Collins, CO 80526 | 2016-11-29 |
| 1205280328 | Abigail Depperschmidt | Physical Therapist | 940 Worthington Circle, Fort Collins, CO 80526 | 2016-04-14 |
| Find all providers in zip 80526 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518580406 | Sovereignty Counseling Services, Pllc | Clinic/Center | 2580 E Harmony Rd Ste 201, Fort Collins, CO 80528-9632 | 2020-05-26 |
| 1588285068 | Poudre Valley Health Care Inc. | Clinic/Center | 1330 Oakridge Dr Unit 100, Fort Collins, CO 80525-9651 | 2020-05-06 |
| 1851921399 | Ashley Boynton, Ph.d., Pllc | Clinic/Center | 412 S Howes St Ste A3, Fort Collins, CO 80521-2878 | 2020-01-23 |
| 1972056547 | Vcphcs X, LLC | Clinic/Center | 2114 Midpoint Dr, Suite 4, Fort Collins, CO 80525 | 2016-07-29 |
| 1174748008 | Light of The Rockies Christian Counseling Center | Clinic/Center | 5236 Strauss Cabin Rd, Fort Collins, CO 80528 | 2007-04-16 |
| 1053923011 | Summitstone Health Partners | Clinic/Center | 1008 Patton St, Fort Collins, CO 80524 | 2020-08-20 |
| 1053932251 | Summitstone Health Partners | Clinic/Center | 2001 S Shields St Ste G, Fort Collins, CO 80526-1834 | 2020-04-29 |
| 1992326177 | Summitstone Health Partners | Clinic/Center | 114 Bristlecone Dr, Fort Collins, CO 80524-2031 | 2020-04-29 |
| 1801417084 | Summitstone Health Partners | Clinic/Center | 700 Centre Ave, Fort Collins, CO 80526-1842 | 2020-04-29 |
| 1609497809 | Summitstone Health Partners | Clinic/Center | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2020-04-29 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80526 |
Please comment or provide details below to improve the information on MENTAL FITNESS COLORADO, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.