Healthcare Provider Details

I. General information

NPI: 1104627041
Provider Name (Legal Business Name): JOANNE S RUPERT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28311 COUNTY ROAD 15
WINDSOR CO
80550-3406
US

IV. Provider business mailing address

28311 COUNTY ROAD 15
WINDSOR CO
80550-3406
US

V. Phone/Fax

Practice location:
  • Phone: 970-222-4193
  • Fax: 970-416-1119
Mailing address:
  • Phone: 970-222-4193
  • Fax: 970-416-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0011378
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: