Active NPI
Third Culture Somatics
- Mental Health Counselor
- Boulder, CO
National Provider Identifier
1053137562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- THIRD CULTURE SOMATICS
- Practice address
- 2735 Iris Ave Ste C3
Boulder, CO 80304-2436 - Phone
- (720) 773-0578
- NPI assigned
- Nov 29, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- M Mikulinsky, LPC
- Title
- Owner and Counselor
- Phone
- (720) 773-0578
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2735 Iris Ave Ste C3
Boulder, CO 80304-2436
Mailing address
2735 Iris Ave Ste C3
Boulder, CO 80304-2436
Phone (720) 773-0578
National Provider Directory
National Provider DirectoryLocations
2735 Iris Ave
Ste C3
Boulder, CO 80304
Phone (720) 773-0578
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732838400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732838400000",
"number": "1053137562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2735 IRIS AVE STE C3",
"city": "BOULDER",
"state": "CO",
"postal_code": "803042436",
"telephone_number": "720-773-0578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2735 IRIS AVE STE C3",
"city": "BOULDER",
"state": "CO",
"postal_code": "803042436",
"telephone_number": "720-773-0578"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THIRD CULTURE SOMATICS",
"organizational_subpart": "NO",
"enumeration_date": "2024-11-29",
"last_updated": "2024-11-29",
"certification_date": "2024-11-29",
"status": "A",
"authorized_official_last_name": "MIKULINSKY",
"authorized_official_first_name": "M",
"authorized_official_title_or_position": "OWNER AND COUNSELOR",
"authorized_official_telephone_number": "720-773-0578",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.