Southern Colorado Counseling and Wellness. PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SOUTHERN COLORADO COUNSELING AND WELLNESS. PLLC

Practice address

417 W 13TH St
Pueblo, CO 81003-2703

Phone

(352) 281-6543

NPI assigned

Aug 23, 2022

Last updated

Aug 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Doug Jones

Title

Owner

Phone

(352) 281-6543

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas Jones, PH.D.

  • Clinical Psychologist
  • Pueblo, CO
  • NPI 1063801579
  Medicare reassignment Care Compare group NPD
• Kimberly A Mahoney

  • Clinical Social Worker
  • Pueblo, CO
  • NPI 1235456393

  Mental Health

  Medicare reassignment Care Compare group NPD
• Angela Maria Calderon, LPC

  • Professional Counselor
  • Pueblo, CO
  • NPI 1598280257
  NPD

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1396464392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032703",
            "telephone_number": "352-281-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032703",
            "telephone_number": "352-281-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COLORADO COUNSELING AND WELLNESS. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-281-6543"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Colorado Clinic PC
• Southern Colorado Clinic PC
• Southern Colorado Clinic PC
• Southern Colorado Clinic PC
• Southern Colorado Comprehensive Court Services
• Southern Colorado Crna Associates Inc
• Southern Colorado Dental Anesthesiology (Villalon Anesthesiology)
• Southern Colorado Dermatology Clinic PC
• Southern Colorado Emergency Medical Associates (Southern Colorado Emergency Medical Associates, Parkview Main)
• Southern Colorado Emergency Specialists

• Clinical Psychologist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.