Julie Mack, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2326 Issued in CO

Practice address

1816 Duchess Dr
Longmont, CO 80501-2034

Phone

(970) 227-2740

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Julie Mack, PH.D., P.C.

  • Clinical Psychologist
  • Loveland, CO
  • NPI 1750613030
  Medicare reassignment Authorized official
• Gary W. Lee

  • Nursing Care Agency
  • Denver, CO
  • NPI 1902958358
  NPD (past)
• Phonda Hackett, PSYD

  • Clinical Psychologist
  • Denver, CO
  • NPI 1326261926
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1417000902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 DUCHESS DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012034",
            "telephone_number": "970-227-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 DUCHESS DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012034",
            "telephone_number": "970-227-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "JULIE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Maass
• Adam Michael Mabry, PA
• Olga Macdonald
• Mikayla Rae Machado
• Analisa Macias, MA
• Michael Charles Mackenzie, M.A.
• Hannah Louise Mackie, M.A., CCC-SLP
• Sandra L. Mackintosh, LCSW
• Jonathan Maczko
• Carolyn Anne Madden, RBT

• Psychologist in Longmont, CO
• Providers in Longmont, CO by specialty
• Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.