Organization Active NPI

Jane Sutliff, PH.D., LLC

  • Clinical Psychologist
  • Louisville, CO
National Provider Identifier
1619003209
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2198 Issued in CO
Legal business name
JANE SUTLIFF, PH.D., LLC
Practice address
357 McCaslin Blvd
Louisville, CO 80027-2941
Phone
(720) 313-3514
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Dr. Jane Sutliff, PH.D.NPI 1760445738
Title
Clinical Psychologist
Phone
(720) 313-3514

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 2198 CO Primary

Addresses

Primary practice location

357 McCaslin Blvd
Louisville, CO 80027-2941

Mailing address

357 McCaslin Blvd
Louisville, CO 80027-2941
Phone (720) 313-3514

Other identifiers 1

IdentifierTypeStateIssuer
24833011MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040909000416 CO Part B Supplier - Clinic/Group Practice 4486620531 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1619003209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 MCCASLIN BLVD",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800272941",
            "telephone_number": "720-313-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 MCCASLIN BLVD",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800272941",
            "telephone_number": "720-313-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANE SUTLIFF, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "SUTLIFF",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "720-313-3514",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24833011",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.