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KATIE HERSOM MA
NPI 1043075161
Counselor - Mental Health in Arvada, CO

Active since February 19, 2024PECOS Enrolled
6863 JOHNSON ST, ARVADA, CO 80004(720) 443-3934 Get Directions Write a Review

NPPES record last updated: March 13, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Katie Hersom Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATIE HERSOM MA (NPI 1043075161) is an individual mental health provider in Arvada, Colorado, licensed in Colorado (LPC.0020286) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1043075161
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKATIE HERSOMCredential: MA
Location Address6863 JOHNSON STArvada, CO 80004-2948
Mailing Address6062 Estes StArvada, CO 80004-5444 · (720) 443-3934
Phone(720) 443-3934
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 19, 2024
Last NPPES UpdateMarch 13, 2024
NPPES CertifiedMarch 13, 2024
✔ NPI 1043075161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CO · LPC.0020286
6863 JOHNSON ST, Arvada, CO 80004
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katie Hersom Ma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072950443
PECOS Enrollment IDI20240320003208
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Katie Hersom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Samantha Ivy LLC
Same address
Clinical
6863 JOHNSON ST
Arvada, CO 80004
  • Reassigned Medicare billing, Colorado enrollment
  • 15 clinicians in this Medicare group
NPI 1427557008 (720) 722-1731

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL B RIFE LCSW
Social Worker (Clinical)
6863 JOHNSON ST
ARVADA, CO 80004
Jefferson County (720) 500-2588
MRS. SAMANTHA SILVERMAN L.C.S.W.
Social Worker (Clinical)
6863 JOHNSON ST
ARVADA, CO 80004
Jefferson County (720) 722-1731
GLENN PERMAR II LPC
Counselor (Mental Health)
6863 JOHNSON ST
ARVADA, CO 80004
Jefferson County (954) 253-1072
SAMANTHA IVY LLC
Social Worker (Clinical)
6863 JOHNSON ST
ARVADA, CO 80004
Jefferson County (720) 722-1731
ELIZABETH NOYES LCSW
Social Worker (Clinical)
6863 JOHNSON ST
ARVADA, CO 80004
Jefferson County (720) 722-1731
ELYSE STANDHART
Social Worker (Clinical)
6863 JOHNSON ST
ARVADA, CO 80004
Jefferson County (720) 722-1731

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katie Hersom's NPI number?

The NPI number for Katie Hersom is 1043075161. It was assigned to this individual provider in the NPPES registry on February 19, 2024.

Where is Katie Hersom located?

Katie Hersom practices at 6863 Johnson St, Arvada, CO 80004. The listed phone number is (720) 443-3934.

What is Katie Hersom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Katie Hersom enrolled in Medicare?

Yes. Katie Hersom is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Katie Hersom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katie Hersom reassigns Medicare benefits to Samantha Ivy LLC (Arvada, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Katie Hersom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Katie Hersom accept?

Health plans from Select Health list Katie Hersom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Katie Hersom was last updated on March 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.