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Dr. Bennett Edgerly , PhD, LPC

Counselor - Professional β€’ Greeley, CO

Active NPI 1114442316 Individual Practitioner Male Practitioner
Practice location in NPPES

1300 N 17th Ave
Greeley, CO 806319584

Call 9703472120 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1300 N 17th Ave

Greeley, CO 806319584

Telephone 9703472120
Organization at the Same NPPES Address or Phone
North Range Behavioral Health Facility NPI 1669431524

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Greeley and Colorado

179 active clinicians are listed under Counselor - Professional with a practice address in Greeley, CO (7,104 in Colorado).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Greeley

2.2% of these 179 clinicians have the CMS telehealth indicator.

14.5% of these 179 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-07-25
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES CO LPC.0016208
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Colorado Division of Professions and Occupations.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Arizona License
LPC-15634 (AZ)
Other Identifier State Licensing Board Of Colorado
LPC.0016208 (CO)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Danielle Matra , MSW

Social Worker - Clinical

NPI 1033511522

Master of Social Work

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location July 25, 2023

Registered at 1300 N 17TH AVE, GREELEY, CO 806319584 (Tel: 9703472120)

πŸ“
Updated Business Mailing Address July 25, 2023

Registered at 1300 N 17TH AVE, GREELEY, CO 806319584 (Tel: 9703472120)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 25, 2023

Counselor (license number reported to NPPES: CO LPC.0016208)

βœ…
NPI Profile Active August 08, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 08, 2017

Registered at 2920 N 4TH ST, FLAGSTAFF, AZ 860041816 (Tel: 9285229400)

πŸ“
Business Mailing Address (Initial Record) August 08, 2017

Registered at 2920 N 4TH ST, FLAGSTAFF, AZ 860041816 (Tel: 9285229400)

πŸ‘€
Provider Name / Credentials (Initial Record) August 08, 2017

Recorded as BENNETT EDGERLY, PH.D., LPC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2017

Counselor (license number reported to NPPES: AZ LPC-15364)

🟒
Initial NPI Registration & Enumeration August 08, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1114442316
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 08, 2017
Last Update: July 25, 2023
Sole Proprietor: No

Mailing Address

1300 N 17th Ave

Greeley, CO 806319584

Phone: 9703472120

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.