SHANNA KETTERIDGE LPC, MC
NPI 1619379112
Counselor - Professional in Fort Collins, CO
NPI Status: Active since September 16, 2014
Contact Information
4856 INNOVATION DR
FORT COLLINS, CO
ZIP 80525
Phone: (970) 494-4200
Fax: (970) 613-4475
- Individual
- Female
- Counselor
- Professional
- PECOS Enrolled
About SHANNA KETTERIDGE
This page provides the complete NPI Profile along with additional information for Shanna Ketteridge, a provider established in Fort Collins, Colorado with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1619379112 assigned on September 2014. The practitioner's primary taxonomy code is 101YP2500X with license number LPC.0013006 (CO). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1619379112
- Provider Name
- SHANNA KETTERIDGE LPC, MC
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4856 INNOVATION DR FORT COLLINS, CO 80525
- Location Phone
- (970) 494-4200
- Location Fax
- (970) 613-4475
- Mailing Address
- 4856 INNOVATION DR FORT COLLINS, CO 80525
- Mailing Phone
- (970) 494-4200
- Mailing Fax
- (970) 613-4475
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-16-2014
- Last Update Date
- 07-24-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- LPC.0013006
- License State
- CO
Medicare Participation & PECOS Enrollment Status
Shanna Ketteridge is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Reviews for SHANNA KETTERIDGE LPC, MC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 1 | 9 | 3 | 7 | 9 | 1 | 1 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 2 | 9 | 6 | 7 | 18 | 1 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 2 + 9 + 6 + 7 + 1 + 8 + 1 + 2 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1619379112 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1629646005 | MRS. JULIE M HANDKE BSN, RN Individual | Registered Nurse | 4856 INNOVATION DR FORT COLLINS, CO 80525 (970) 494-4200 |
| 1225781289 | MYRIA JESSIKA DAVIS BS, MA, LPCC Individual | Occupational Therapist (Mental Health) | 4856 INNOVATION DR FORT COLLINS, CO 80525 (970) 494-4200 |
| 1306551734 | FERNANDA ALARCON-AVILA Individual | Case Manager/Care Coordinator | 4856 INNOVATION DR FORT COLLINS, CO 80525 (970) 494-4200 |
| 1346955796 | BRYNN L HICKEY Individual | Technician, Pathology (Phlebotomy) | 4856 INNOVATION DR FORT COLLINS, CO 80525 (970) 397-7815 |
| 1003472002 | MORGAN RICE CAT Individual | Counselor (Addiction (Substance Use Disorder)) | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1033995592 | SARAH M RAMIREZ Individual | Case Manager/Care Coordinator | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1184955338 | KELLY T WINTERS LPC, MA Individual | Counselor (Professional) | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1245014752 | KYLE A ROGERS-LOFT Individual | Peer Specialist | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1396520219 | CAITLIN TAYLOR Individual | Nurse's Aide | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1659155281 | SARAH CONRAD Individual | Case Manager/Care Coordinator | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1720482953 | DEBORAH J WALKER BSW Individual | Case Manager/Care Coordinator | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1750165387 | REINA J SOTELO RAMOS Individual | Case Manager/Care Coordinator | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1750166658 | AZUCENA RAMIREZ Individual | Case Manager/Care Coordinator | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1780469205 | DESTINY R WREN Individual | Counselor (Mental Health) | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1851092860 | CHRISTINA RAMIREZ CMA Individual | Nurse's Aide | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1114706843 | BREANNA PESINA Individual | Nurse's Aide | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1174301311 | KATHERINE L BARR Individual | Peer Specialist | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1174301378 | MEGAN JORGENSON Individual | Pharmacy Technician | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1205612116 | MARSHALL BARRER Individual | Case Manager/Care Coordinator | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
| 1437755717 | JASZMYNE BEVERLY LPC Individual | Counselor (Professional) | 4856 INNOVATION DR STE B FORT COLLINS, CO 80525 (970) 494-4200 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619379112, enumerated in the NPI registry as an "individual" on September 16, 2014
The provider is located at 4856 Innovation Dr Fort Collins, Co 80525 and the phone number is (970) 494-4200
The provider's speciality is Counselor with taxonomy code 101YP2500X with a focus in Professional
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
This NPI record was last updated on September 16, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.