Individual provider Active NPI

Susan Laurie Jones, PSYD

  • Psychologist
  • Boulder, CO
National Provider Identifier
1205926631
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1679 Issued in CO
Practice address
2955 Valmont Rd.
Ste. 230
Boulder, CO 80301
Phone
(303) 448-4915
Fax
(303) 444-2372
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1679 CO Primary

Addresses

Primary practice location

2955 Valmont Rd.
Ste. 230
Boulder, CO 80301

Mailing address

1750 30TH St
#139
Boulder, CO 80301-1029
Phone (303) 448-4915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118000114 CO Practitioner - Clinical Psychologist 6103012034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2955 Valmont Rd
Suite 230
Boulder, CO 80301-1360
Phone (303) 448-4915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1679COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Services Corporation Psychologist CurrentSince Jul 12, 2010 Accepting new patients

Locations

1750 30th St
Boulder, CO 80301

1750 30th St
#139
Boulder, CO 80301

2955 Valmont Rd
Ste 230
Boulder, CO 80301
Phone (303) 448-4915

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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1205926631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 30TH ST",
            "address_2": "#139",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011029",
            "telephone_number": "303-448-4915",
            "fax_number": "303-444-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 VALMONT RD.",
            "address_2": "STE. 230",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80301",
            "telephone_number": "303-448-4915",
            "fax_number": "303-444-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SUSAN",
        "middle_name": "LAURIE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "1679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.