Active NPI
None
- Adult Mental Health Clinic/Center
- Boulder, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- Legal business name
- NONE
- Practice address
- 9347 Sugarloaf Rd
Boulder, CO 80302-9221 - Phone
- (415) 264-9504
- NPI assigned
- Feb 21, 2019
- Last updated
- Feb 21, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kenneth McDonald, PSY.D.
- Title
- Owner
- Phone
- (415) 264-9504
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | Primary |
Addresses
Primary practice location
9347 Sugarloaf Rd
Boulder, CO 80302-9221
Mailing address
9347 Sugarloaf Rd
Boulder, CO 80302-9221
Phone (415) 264-9504
Other practice location 1
363 East Elkhorn Ave
Estes Park, CO 80517
Phone (415) 264-9504
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Clinical Psychologist
- Boulder, CO
- NPI 1366910028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1550707200000",
"number": "1457818932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9347 SUGARLOAF RD",
"city": "BOULDER",
"state": "CO",
"postal_code": "803029221",
"telephone_number": "415-264-9504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9347 SUGARLOAF RD",
"city": "BOULDER",
"state": "CO",
"postal_code": "803029221",
"telephone_number": "415-264-9504"
}
],
"practiceLocations": [
{
"address_1": "363 East Elkhorn Ave",
"address_purpose": "LOCATION",
"city": "Estes Park",
"state": "CO",
"postal_code": "80517",
"country_code": "US",
"telephone_number": "415-264-9504",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "NONE",
"organizational_subpart": "NO",
"enumeration_date": "2019-02-21",
"last_updated": "2019-02-21",
"status": "A",
"authorized_official_last_name": "MCDONALD",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "415-264-9504",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSY.D."
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.