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ETHAN DAHLBERG
NPI 1073284634
Counselor - Professional in Colorado Springs, CO

Active since September 23, 2021PECOS EnrolledAccepts Medicare Assignment
5360 N ACADEMY BLVD STE 290, COLORADO SPRINGS, CO 80918(719) 286-0242 Get Directions Write a Review

NPPES record last updated: June 8, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 8, 2023, Sep 23, 2021 (2 updates tracked since 2021).

About Ethan Dahlberg NPPES

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

ETHAN DAHLBERG (NPI 1073284634) is an individual professional provider in Colorado Springs, Colorado, licensed in Colorado (LPC.0019385) and active in the NPI registry since September 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1073284634
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameETHAN DAHLBERG
Location Address5360 N ACADEMY BLVD STE 290Colorado Springs, CO 80918-4038
Mailing Address5360 N Academy Blvd Ste 290Colorado Springs, CO 80918-4038 · (719) 434-2160
Phone(719) 286-0242
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 23, 2021
Last NPPES UpdateJune 8, 20232 updates tracked since enumeration
NPPES CertifiedJune 8, 2023
✔ NPI 1073284634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in CO · LPC.0019385
5360 N ACADEMY BLVD STE 290, Colorado Springs, CO 80918
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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Dahlberg is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870025992
PECOS Enrollment IDI20241015000757
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.

Other Providers at the Same Location NPPES 20

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

MRS. YOLANDA YVONNE HODGES CAC III
Counselor (Addiction (Substance Use Disorder))
5360 N ACADEMY BLVD STE 290
COLORADO SPRINGS, CO 80918
El Paso County (719) 434-2061
LEAH ANN MILLER
Counselor (Addiction (Substance Use Disorder))
5360 N ACADEMY BLVD STE 290
COLORADO SPRINGS, CO 80918
El Paso County (719) 434-2061
KRISTINE LANE BS CAC III
Counselor (Addiction (Substance Use Disorder))
5360 N ACADEMY BLVD STE 290
COLORADO SPRINGS, CO 80918
El Paso County (719) 434-2061
MR. KENDALL WATTS BS, MA
Counselor (Addiction (Substance Use Disorder))
5360 N ACADEMY BLVD STE 290
COLORADO SPRINGS, CO 80918
El Paso County (719) 434-2061
NATASHA COOLEY
Counselor (Addiction (Substance Use Disorder))
5360 N ACADEMY BLVD STE 290
COLORADO SPRINGS, CO 80918
El Paso County (719) 434-2061
GLORIA DENISE IRMO LPN
Licensed Practical Nurse
5360 N ACADEMY BLVD STE 290
COLORADO SPRINGS, CO 80918
El Paso County (719) 434-2061
MARIA JUAREZ LPCC
Counselor (Mental Health)
5360 N ACADEMY BLVD STE 290
COLORADO SPRINGS, CO 80918
El Paso County (719) 434-2061
BRIANNE MARTINEZ RP, LPCC
Counselor (Addiction (Substance Use Disorder))
5360 N ACADEMY BLVD STE 290
COLORADO SPRINGS, CO 80918
El Paso County (719) 434-2061

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 Ethan Dahlberg's NPI number?

The NPI number for Ethan Dahlberg is 1073284634. It was assigned to this individual provider in the NPPES registry on September 23, 2021.

Where is Ethan Dahlberg located?

Ethan Dahlberg practices at 5360 N Academy Blvd Ste 290, Colorado Springs, CO 80918. The listed phone number is (719) 286-0242.

What is Ethan Dahlberg's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Ethan Dahlberg enrolled in Medicare?

Yes. Ethan Dahlberg is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ethan Dahlberg accept?

Health plans from Providence Health Plan list Ethan Dahlberg 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 Ethan Dahlberg was last updated on June 8, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.