MEDICARE: HEART CENTERED COUNSELING, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	103TC0700X	Clinical Psychologist
3	1041C0700X	Clinical Social Worker
4	106H00000X	Marriage & Family Therapist
5	2084P0800X	Psychiatry Physician
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
7	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558158584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART CENTERED COUNSELING, PC

Provider Business Mailing Address
First Line	:	215 W OAK ST FL 4
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2734
Country	:	US
Telephone Number	:	970-310-3406
Fax Number	:	888-965-4615

Provider Business Practice Location Address
First Line	:	6071 E WOODMEN RD STE 325
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-2612
Country	:	US
Telephone Number	:	970-310-3406
Fax Number	:

Authorized Official
Title or Position	:	CHIEF LEGAL OFFICER
Name	:	RYAN PARDO
Credential	:
Telephone Number	:	206-399-1493

Provider Enumeration Date	:	04/23/2025
Last Update Date	:	04/23/2025

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