Carly Sedgwick, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CARLY SEDGWICK, LLC

Practice address

2860 Kalmia Ave Apt 204
Boulder, CO 80301-5912

Phone

(505) 304-5234

NPI assigned

Mar 2, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carly Renee Sedgwick, LPC

Title

Owner

Phone

(505) 304-5234

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519948800000",
    "number": "1144722406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 KALMIA AVE APT 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803015912",
            "telephone_number": "505-304-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 KALMIA AVE APT 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803015912",
            "telephone_number": "505-304-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLY SEDGWICK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-02",
        "last_updated": "2018-03-02",
        "status": "A",
        "authorized_official_last_name": "SEDGWICK",
        "authorized_official_first_name": "CARLY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-304-5234",
        "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": []
}

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• Mental Health Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.