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JUDSON WILLIS
NPI 1669360095
Counselor - Professional in Colorado Springs, CO

Active since June 25, 2025PECOS Enrolled
140 S PARKSIDE DR, COLORADO SPRINGS, CO 80910(719) 358-7338 Get Directions Write a Review

NPPES record last updated: June 26, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Judson Willis NPPES

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

JUDSON WILLIS (NPI 1669360095) is an individual professional provider in Colorado Springs, Colorado, licensed in Colorado (LPC.0022027) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1669360095
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJUDSON WILLIS
Location Address140 S PARKSIDE DRColorado Springs, CO 80910-3129
Mailing Address4286 Gunbarrel DrColorado Springs, CO 80925-1005 · (478) 334-8467
Phone(719) 358-7338
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateJune 25, 2025
Last NPPES UpdateJune 26, 2025
NPPES CertifiedJune 26, 2025
✔ NPI 1669360095 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.0022027
140 S PARKSIDE DR, Colorado Springs, CO 80910
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Judson Willis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4284135633
PECOS Enrollment IDI20250828002174
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 10

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

MRS. ELIZABETH DAWN MARTIN CACIII
Counselor (Addiction (Substance Use Disorder))
140 S PARKSIDE DR
COLORADO SPRINGS, CO 80910
El Paso County (719) 358-7338
CATHERINE EWERT MA, LPC, ADDC, NCC
Counselor (Professional)
140 S PARKSIDE DR
COLORADO SPRINGS, CO 80910
El Paso County (719) 358-7338
E DAWN MARTIN CACIII LLC
Clinic/Center (Primary Care)
140 S PARKSIDE DR
COLORADO SPRINGS, CO 80910
El Paso County (719) 358-7338
E DAWN MARTIN CACIII LLC
Community/Behavioral Health
140 S PARKSIDE DR
COLORADO SPRINGS, CO 80910
El Paso County (719) 358-7338
E DAWN MARTIN CACIII LLC
Clinic/Center (Rehabilitation, Substance Use Disorder)
140 S PARKSIDE DR
COLORADO SPRINGS, CO 80910
El Paso County (719) 358-7338
LEAH AGEE LPC
Counselor (Professional)
140 S PARKSIDE DR
COLORADO SPRINGS, CO 80910
El Paso County (719) 388-3778
DONNIE FENNIMORE CAS
Counselor (Addiction (Substance Use Disorder))
140 S PARKSIDE DR
COLORADO SPRINGS, CO 80910
El Paso County (719) 358-7338
ERIN DAWN LAPIOLI CAS
Counselor (Addiction (Substance Use Disorder))
140 S PARKSIDE DR
COLORADO SPRINGS, CO 80910
El Paso County (719) 358-7338

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 Judson Willis's NPI number?

The NPI number for Judson Willis is 1669360095. It was assigned to this individual provider in the NPPES registry on June 25, 2025.

Where is Judson Willis located?

Judson Willis practices at 140 S Parkside Dr, Colorado Springs, CO 80910. The listed phone number is (719) 358-7338.

What is Judson Willis's specialty?

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

Is Judson Willis enrolled in Medicare?

Yes. Judson Willis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Judson Willis was last updated on June 26, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.