Active NPI
Ellen Sevigny, MA
- Counselor
- Boulder, CO
National Provider Identifier
1174014922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- NLC.0108363
- Practice address
- 726 Pearl St Ste C
Boulder, CO 80302-3609 - Phone
- (120) 766-4922
- NPI assigned
- May 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NLC.0108363 | CO | Primary |
Addresses
Primary practice location
726 Pearl St Ste C
Boulder, CO 80302-3609
Mailing address
2201 Pearl St Apt 319
Boulder, CO 80302-4683
Phone (207) 664-9220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NLC.0108363 | Other | CO | REGISTERED PSYCHOTHERAPIST |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NLC.0108363 | CO | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527379200000",
"number": "1174014922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 PEARL ST APT 319",
"city": "BOULDER",
"state": "CO",
"postal_code": "803024683",
"telephone_number": "207-664-9220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 PEARL ST STE C",
"city": "BOULDER",
"state": "CO",
"postal_code": "803023609",
"telephone_number": "120-766-4922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVIGNY",
"first_name": "ELLEN",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-27",
"last_updated": "2018-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "NLC.0108363",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PSYCHOTHERAPIST",
"identifier": "NLC.0108363",
"state": "CO"
}
],
"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 May 27, 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.