Active NPI
Carol Ann Keymer, LPC
- Mental Health Counselor
- Boulder, CO
National Provider Identifier
1578739462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3323
- Practice address
- 6078 Olde Stage Rd
Boulder, CO 80302-9497 - Phone
- (720) 406-7995
- Fax
- (303) 440-8646
- NPI assigned
- May 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3323 | CO | Primary |
| Mental Health Counselor | 101YM0800X | 2999 | OK | |
| Psychoanalysis Psychologist | 103TP0814X | 2203 | OK |
Addresses
Primary practice location
6078 Olde Stage Rd
Boulder, CO 80302-9497
Mailing address
6078 Olde Stage Road
Boulder, CO 80302
Phone (720) 406-7995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2999 | OK | MD | Mental Health Counselor |
| 2203 | OK | MD | Optometrist |
| 3323 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209600000000",
"number": "1578739462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6078 OLDE STAGE ROAD",
"city": "BOULDER",
"state": "CO",
"postal_code": "80302",
"telephone_number": "720-406-7995",
"fax_number": "303-440-8646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6078 OLDE STAGE RD",
"city": "BOULDER",
"state": "CO",
"postal_code": "803029497",
"telephone_number": "720-406-7995",
"fax_number": "303-440-8646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEYMER",
"first_name": "CAROL",
"middle_name": "ANN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-01",
"last_updated": "2008-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "3323",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "2999",
"primary": false
},
{
"code": "103TP0814X",
"taxonomy_group": "",
"desc": "Psychologist, Psychoanalysis",
"state": "OK",
"license": "2203",
"primary": false
}
],
"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 May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.