Carol Hathaway-Clark, PH.D., LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1789 Issued in CO

Legal business name

CAROL HATHAWAY-CLARK, PH.D., LLC

Practice address

3393 Iris Ave Ste 104
Boulder, CO 80301-1956

Phone

(303) 440-0295

NPI assigned

May 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Carol Hathaway-Clark, PH.D.

Title

Clinical Psychologist

Phone

(303) 440-0295

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242000000000",
    "number": "1558595181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3393 IRIS AVE STE 104",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011956",
            "telephone_number": "303-440-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3393 IRIS AVE STE 104",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011956",
            "telephone_number": "303-440-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL HATHAWAY-CLARK, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-05-11",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY-CLARK",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "303-440-0295",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CO",
            "license": "1789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Boulder, CO
• Providers in Boulder, CO by specialty
• Community/Behavioral Health Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.