| Diversus Health Inc | |
|
220 Ruskin Dr Colorado Springs CO 80910 | |
| (719) 572-6100 | |
| (719) 572-6080 |
| Full Name | Diversus Health Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 220 Ruskin Dr, Colorado Springs, Colorado |
| Authorized Official Name and Position | Gene Contreras (VP, ACCOUNTING & FINANCE) |
| Authorized Official Contact | 7195726197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diversus Health Inc 220 Ruskin Drive Colorado Springs CO 80910 Ph: (719) 572-6100 | Diversus Health Inc 220 Ruskin Dr Colorado Springs CO 80910 Ph: (719) 572-6100 |
| NPI Number | 1043260243 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 01/09/2024 |
| Certification Date | 01/09/2024 |
| Medicare PECOS PAC ID | 7719879204 |
|---|---|
| Medicare Enrollment ID | O20040329000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043260243 | NPI | - | NPPES |
| 04899084 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Frederick Michel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720092802 PECOS PAC ID: 8527095686 Enrollment ID: I20060310000112 |
| Provider Name | Robert G Bleck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780700302 PECOS PAC ID: 3779643093 Enrollment ID: I20081117000588 |
| Provider Name | Daniel D Hammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518116839 PECOS PAC ID: 2961541495 Enrollment ID: I20091123000438 |
| Provider Name | Marilyn R Warren |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1477569473 PECOS PAC ID: 3577561869 Enrollment ID: I20110124001242 |
| Provider Name | Lindsay Gries |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699929034 PECOS PAC ID: 0244406635 Enrollment ID: I20120106000324 |
| Provider Name | Katie Lynn Blickenderfer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942439138 PECOS PAC ID: 2365690575 Enrollment ID: I20120913000159 |
| Provider Name | Jose D Martinez-gamba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285935262 PECOS PAC ID: 4880823996 Enrollment ID: I20140213001107 |
| Provider Name | Travis Porter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396887451 PECOS PAC ID: 2264664085 Enrollment ID: I20140410000196 |
| Provider Name | Brian W Schneider |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508146424 PECOS PAC ID: 1658509427 Enrollment ID: I20140625000437 |
| Provider Name | Justin Cp Barry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972924074 PECOS PAC ID: 6305165994 Enrollment ID: I20150504000542 |
| Provider Name | Cynthia L Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295860211 PECOS PAC ID: 4880976687 Enrollment ID: I20170130002674 |
| Provider Name | Alicia L Showalter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043463540 PECOS PAC ID: 9830474071 Enrollment ID: I20170330000544 |
| Provider Name | Vernon T Mccord |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952832537 PECOS PAC ID: 1759667108 Enrollment ID: I20170419001259 |
| Provider Name | Michelle R Palu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285881334 PECOS PAC ID: 6901183656 Enrollment ID: I20170505000067 |
| Provider Name | Chong A Crouch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104364744 PECOS PAC ID: 7214209915 Enrollment ID: I20170815003573 |
| Provider Name | Marissa Elaine Lamastus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154898849 PECOS PAC ID: 3173877974 Enrollment ID: I20181114001657 |
| Provider Name | Jose Mathew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447690474 PECOS PAC ID: 8921348871 Enrollment ID: I20190313000441 |
| Provider Name | Melinda Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164492955 PECOS PAC ID: 3779824396 Enrollment ID: I20190409001689 |
| Provider Name | Linda F Koch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649430687 PECOS PAC ID: 6709013576 Enrollment ID: I20190412001564 |
| Provider Name | Rebecca Cecilia Moreno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942853049 PECOS PAC ID: 4082941836 Enrollment ID: I20190816000580 |
| Provider Name | Ian Peters |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821385865 PECOS PAC ID: 9931493046 Enrollment ID: I20190826001813 |
| Provider Name | Eva M Kolb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750724951 PECOS PAC ID: 9133491772 Enrollment ID: I20191008002750 |
| Provider Name | Jessica Floria |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285268615 PECOS PAC ID: 5890123160 Enrollment ID: I20200319002363 |
| Provider Name | Jordan Leigh Frasier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609153790 PECOS PAC ID: 2567874670 Enrollment ID: I20201215000603 |
| Provider Name | Amanda M Bernheim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629599758 PECOS PAC ID: 8123435906 Enrollment ID: I20210323000503 |
| Provider Name | Kimra Kay Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457744849 PECOS PAC ID: 9830418763 Enrollment ID: I20210601000536 |
| Provider Name | Luke Dirks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750714655 PECOS PAC ID: 1456751338 Enrollment ID: I20210615000566 |
| Provider Name | Chelsea Storm Elaann Griffith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013383090 PECOS PAC ID: 1052620218 Enrollment ID: I20211104000247 |
| Provider Name | Vivian Palacios Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730658816 PECOS PAC ID: 5890120059 Enrollment ID: I20220307000101 |
| Provider Name | Ugochi N Nwaobi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780237156 PECOS PAC ID: 6800274945 Enrollment ID: I20220602001058 |
| Provider Name | Meagan E Herbst |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164155263 PECOS PAC ID: 9830570399 Enrollment ID: I20220715000969 |
| Provider Name | Luana Rutherford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194287391 PECOS PAC ID: 4082048038 Enrollment ID: I20220725001658 |
| Provider Name | Virginia Ann Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336874692 PECOS PAC ID: 7618359548 Enrollment ID: I20220809001163 |
| Provider Name | Lacy Monday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518394139 PECOS PAC ID: 3779881016 Enrollment ID: I20220829000295 |
| Provider Name | Crysta Caryll Shiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215206008 PECOS PAC ID: 7214362078 Enrollment ID: I20220901001124 |
| Provider Name | Adam M Steffens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598484701 PECOS PAC ID: 4082099536 Enrollment ID: I20220919003282 |
| Provider Name | Monica C Nichols |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851488795 PECOS PAC ID: 9032365390 Enrollment ID: I20230117002553 |
| Provider Name | Martha Sue Splettstoesser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407013212 PECOS PAC ID: 2163895871 Enrollment ID: I20230228001893 |
| Provider Name | Tisha Dawn Montesano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609576651 PECOS PAC ID: 3678947041 Enrollment ID: I20230327000526 |
| Provider Name | Abimbola Olufemi Layeni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811962384 PECOS PAC ID: 2466584131 Enrollment ID: I20230526002212 |
| Provider Name | Alicia Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124573746 PECOS PAC ID: 4880021583 Enrollment ID: I20230825000566 |
| Provider Name | Samantha Ione Kurtenbach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780396341 PECOS PAC ID: 2466816012 Enrollment ID: I20230914002285 |
| Provider Name | Stephanie D Kutnar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538946413 PECOS PAC ID: 2264887801 Enrollment ID: I20231017001406 |
| Provider Name | Cristal C Campocasso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942790803 PECOS PAC ID: 8325495823 Enrollment ID: I20231106000432 |
| Provider Name | Ashley Rooks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154864320 PECOS PAC ID: 9335596105 Enrollment ID: I20231116000228 |
| Provider Name | David Lee Franks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558860262 PECOS PAC ID: 7911354790 Enrollment ID: I20231116000533 |
| Provider Name | Justin M Billot |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003453937 PECOS PAC ID: 0547617268 Enrollment ID: I20231116002673 |
| Provider Name | Kari L Gonzales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104248335 PECOS PAC ID: 0941657662 Enrollment ID: I20231116002900 |
| Provider Name | Teresa Guthmiller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194090704 PECOS PAC ID: 5496102121 Enrollment ID: I20231116003371 |
| Provider Name | Kimberly Smith Faust |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003396516 PECOS PAC ID: 2466800172 Enrollment ID: I20231117002814 |
| Provider Name | Andrea Ximena Alban |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083215248 PECOS PAC ID: 6002264835 Enrollment ID: I20231204003161 |
| Provider Name | Lori Ellen Stalcar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003129370 PECOS PAC ID: 1759730278 Enrollment ID: I20231209000203 |
| Provider Name | Rebecca J Bianco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285745596 PECOS PAC ID: 6204285596 Enrollment ID: I20231212002398 |
| Provider Name | Nicole Hannah Boggan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386202141 PECOS PAC ID: 1355790528 Enrollment ID: I20231213001627 |
| Provider Name | Carmen M Gutierrez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497478424 PECOS PAC ID: 2668821877 Enrollment ID: I20231213003229 |
| Provider Name | Amanda Lynn Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841598372 PECOS PAC ID: 5698124766 Enrollment ID: I20231214001866 |
| Provider Name | Heather Leigh Girardin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427354802 PECOS PAC ID: 7719336825 Enrollment ID: I20231214003454 |
| Provider Name | Jetta Lee Colten |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356619159 PECOS PAC ID: 8123478013 Enrollment ID: I20231218004116 |
| Provider Name | Heather Foster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528257748 PECOS PAC ID: 7113377060 Enrollment ID: I20231219001808 |
| Provider Name | Paul Gross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134617038 PECOS PAC ID: 5799135679 Enrollment ID: I20231219002998 |
| Provider Name | Ashley Marie Oldfield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215561253 PECOS PAC ID: 0244680809 Enrollment ID: I20231221002752 |
| Provider Name | Desiree Michelle James |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386278588 PECOS PAC ID: 2062862683 Enrollment ID: I20231222001391 |
| Provider Name | Jennifer R Ivan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871956250 PECOS PAC ID: 7214387455 Enrollment ID: I20231229001297 |
| Provider Name | Anneliese M Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346886744 PECOS PAC ID: 8527418771 Enrollment ID: I20231229001529 |
| Provider Name | Jay F Derosa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396524245 PECOS PAC ID: 9335590371 Enrollment ID: I20240104000297 |
| Provider Name | Gregory A Lanning |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013062231 PECOS PAC ID: 2163873142 Enrollment ID: I20240104001445 |
| Provider Name | Deanna M Ward |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679901623 PECOS PAC ID: 6709237688 Enrollment ID: I20240104001855 |
| Provider Name | Mariel Garcia |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356404495 PECOS PAC ID: 1951752013 Enrollment ID: I20240112002646 |
| Provider Name | Lauren R Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871219154 PECOS PAC ID: 4385096155 Enrollment ID: I20240117001864 |
| Provider Name | Christa Kaley Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760017271 PECOS PAC ID: 2466805510 Enrollment ID: I20240125001652 |
| Provider Name | Roisin Mhairi Osborn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952034837 PECOS PAC ID: 2961855911 Enrollment ID: I20240126000528 |
| Provider Name | Brandee Horne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417359621 PECOS PAC ID: 8921451808 Enrollment ID: I20240126002217 |
| Provider Name | Samantha Kay Kiourtzidis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548713704 PECOS PAC ID: 5991158792 Enrollment ID: I20240129001655 |
| Provider Name | Sherry Lynn Graham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033417407 PECOS PAC ID: 1850744525 Enrollment ID: I20240130000066 |
| Provider Name | Sarah Rae Walgenbach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659713832 PECOS PAC ID: 8527411800 Enrollment ID: I20240202001867 |
| Provider Name | Brianna Rae Lymuel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326744970 PECOS PAC ID: 3971946211 Enrollment ID: I20240203000431 |
| Provider Name | Eleasa Adella Milano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013687920 PECOS PAC ID: 1052754082 Enrollment ID: I20240207000911 |
| Provider Name | Lysandra Presley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386180529 PECOS PAC ID: 0244515104 Enrollment ID: I20240213001181 |
| Provider Name | Michele Renee Harvey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104698497 PECOS PAC ID: 5597109983 Enrollment ID: I20240213003629 |
| Provider Name | Tammy Christine Laborde |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710010491 PECOS PAC ID: 3577907799 Enrollment ID: I20240215002828 |
| Provider Name | Christina Marie Rauth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992399497 PECOS PAC ID: 1355785197 Enrollment ID: I20240220001806 |
| Provider Name | Matthew Austin Powers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265104137 PECOS PAC ID: 3375987993 Enrollment ID: I20240221004360 |
| Provider Name | Marjorie M Knighton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194822866 PECOS PAC ID: 2668817164 Enrollment ID: I20240223002314 |
| Provider Name | Roberta M Renfro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417145954 PECOS PAC ID: 3375988637 Enrollment ID: I20240227002493 |
| Provider Name | Kiara Brie Ninos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023777513 PECOS PAC ID: 0547606675 Enrollment ID: I20240312002700 |
| Provider Name | Erin N Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366575912 PECOS PAC ID: 9133565021 Enrollment ID: I20240314000228 |
Beyond Beautiful, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 716 N Tejon Ave # 7, Colorado Springs, CO 80903 Phone: 719-598-7800 Fax: 719-204-3829 | |
New Solutions Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13879 Single Leaf Ct, Colorado Springs, CO 80921 Phone: 719-231-0527 | |
Peak Interventions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1118 N Arcadia St, Colorado Springs, CO 80903 Phone: 720-384-5312 | |
Btti Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3010 Willamette Pl, Colorado Springs, CO 80909 Phone: 719-442-0144 | |
Restorative Place Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2790 N Academy Blvd Ste 206, Colorado Springs, CO 80917 Phone: 719-259-3834 | |
Lentz Psychological Services, P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5855 Lehman Dr Ste 202, Colorado Springs, CO 80918 Phone: 719-551-9911 Fax: 719-596-9636 | |
Lifestance Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9475 Briar Village Pt Ste 320, Colorado Springs, CO 80920 Phone: 970-310-3406 Fax: 888-965-4615 |