Individual provider Active NPI

Vasudha Daver Park, M.A., LPC

  • Professional Counselor
  • Boulder, CO
National Provider Identifier
1205276649
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0013989 Issued in CO
Practice address
737 29TH St Ste 200F
Boulder, CO 80303-2474
Phone
(720) 432-7723
NPI assigned
Jun 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X LPC.0013989 CO Primary

Addresses

Primary practice location

737 29TH St Ste 200F
Boulder, CO 80303-2474

Mailing address

1930 Bluebell Ave
Boulder, CO 80302-8024
Phone (510) 501-9558

Other names 1

  • Vasudha Daver Former name

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

LicenseStateTypeSpecialty
LPC.0013989COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Moksha LLC Mental Health Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1205276649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BLUEBELL AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803028024",
            "telephone_number": "510-501-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 29TH ST STE 200F",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032474",
            "telephone_number": "720-432-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "VASUDHA",
        "middle_name": "DAVER",
        "credential": "M.A., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-30",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0013989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VASUDHA",
            "last_name": "DAVER",
            "credential": "M.A., LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Oct 8, 2025; 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.