Individual provider Active NPI

Laurel Christa Mulholland, LSW

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1164729349
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
598 Issued in CO
Practice address
75 Manhattan Dr
Suite 208
Boulder, CO 80303-4254
Phone
(720) 224-3722
NPI assigned
Feb 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 598 CO Primary

Addresses

Primary practice location

75 Manhattan Dr
Suite 208
Boulder, CO 80303-4254

Mailing address

75 Manhattan Dr
Suite 208
Boulder, CO 80303-4254
Phone (720) 224-3722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
598COMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1164729349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MANHATTAN DR",
            "address_2": "SUITE 208",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034254",
            "telephone_number": "720-224-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MANHATTAN DR",
            "address_2": "SUITE 208",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034254",
            "telephone_number": "720-224-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHOLLAND",
        "first_name": "LAUREL",
        "middle_name": "CHRISTA",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "598",
            "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 Feb 23, 2011; 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.