Jeb Bennett LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

JEB BENNETT LCSW

Practice address

800 Laramie Blvd Unit B
Boulder, CO 80304-4785

Phone

(303) 946-0236

NPI assigned

Nov 24, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Gerald W Bennett, LCSW

Title

Owner

Phone

(303) 946-0236

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1538826573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 LARAMIE BLVD UNIT B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044785",
            "telephone_number": "303-946-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 LARAMIE BLVD UNIT B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044785",
            "telephone_number": "303-946-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEB BENNETT LCSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-946-0236",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Boulder",
            "affiliation": "N",
            "address_1": "800 Laramie Blvd Unit B",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803044785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah Sampson Jarvis, L.C.S.W.
• Lauren Jasilli, FNP-C
• Jay E Swartzwelter D.D.S.
• Jay Wilson D.C. P.C.
• Theresa Jeannette-Palermo, LCSW
• Barbara F Jedrzejek, PSYD, LP
• Jeffrey B Holland OD PC
• Jeffrey H Wong, D.D.S. M.S.
• Jeffrey Walters PC
• Sarah Jeffrey

• Mental Health Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.