Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACQUELINE RAE ANDERSON LP
NPI 1386137016
Psychologist in Broomfield, CO

Active since June 07, 2018PECOS Enrolled
12303 AIRPORT WAY STE 125, BROOMFIELD, CO 80021(970) 310-3406 Get Directions Write a Review

NPPES record last updated: October 12, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 12, 2026, Jul 31, 2024, Jan 3, 2024 (3 updates tracked since 2024).

About Jacqueline Rae Anderson Lp NPPES

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

JACQUELINE RAE ANDERSON LP (NPI 1386137016) is an individual psychologist in Broomfield, Colorado, licensed in Colorado (PSY.0005796) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fort Collins.

NPPES Registry Identity

NPI1386137016
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameJACQUELINE RAE ANDERSONCredential: LP
Location Address12303 AIRPORT WAY STE 125Broomfield, CO 80021-2729
Mailing Address12303 Airport Way Ste 125Broomfield, CO 80021-2729 · (970) 310-3406
Sole ProprietorYes
Enumeration DateJune 7, 2018
Last NPPES UpdateOctober 12, 20263 updates tracked since enumeration
NPPES CertifiedOctober 12, 2026
✔ NPI 1386137016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CO · PSY.0005796
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · SchoolTaxonomy 103TS0200X · License PSY.0005796 (CO)
12303 AIRPORT WAY STE 125, Broomfield, CO 80021

Secondary Practice Location 1

Location 1215 W Oak St Fl 4Fort Collins, CO 80521-2734 · Phone (970) 310-3406

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Rae Anderson Lp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Jacqueline Anderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health
12303 AIRPORT WAY STE 125
Broomfield, CO 80021
  • Reassigned Medicare billing, Colorado enrollment
  • 390 clinicians in this Medicare group

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 15

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

Social Worker (Clinical)
12303 AIRPORT WAY STE 125
BROOMFIELD, CO 80021
Counselor (Professional)
12303 AIRPORT WAY STE 125
BROOMFIELD, CO 80021
Counselor (Mental Health)
12303 AIRPORT WAY STE 125
BROOMFIELD, CO 80021
Social Worker (Clinical)
12303 AIRPORT WAY STE 125
BROOMFIELD, CO 80021
Marriage & Family Therapist
12303 AIRPORT WAY STE 125
BROOMFIELD, CO 80021
Counselor (Mental Health)
12303 AIRPORT WAY STE 125
BROOMFIELD, CO 80021
Counselor (Professional)
12303 AIRPORT WAY STE 125
BROOMFIELD, CO 80021
Social Worker (Clinical)
12303 AIRPORT WAY STE 125
BROOMFIELD, CO 80021

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 Jacqueline Anderson's NPI number?

The NPI number for Jacqueline Anderson is 1386137016. It was assigned to this individual provider in the NPPES registry on June 7, 2018.

Where is Jacqueline Anderson located?

Jacqueline Anderson practices at 12303 Airport Way Ste 125, Broomfield, CO 80021. The listed phone number is (970) 310-3406.

What is Jacqueline Anderson's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jacqueline Anderson enrolled in Medicare?

Yes. Jacqueline Anderson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacqueline Anderson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Anderson reassigns Medicare benefits to Heart Centered Counseling, PC (Broomfield, 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 Jacqueline Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacqueline Anderson was last updated on October 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days 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.