Active NPI
Dianne K. Clark, CERTIFIED MASSAGE TH
- Music Therapist
- Lakewood, CO
National Provider Identifier
1700108461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 021432
- Practice address
- 9955 W. 20TH Ave
Lakewood, CO 80215 - Phone
- (303) 986-0865
- NPI assigned
- Feb 23, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 021432 | CO | Primary |
Addresses
Primary practice location
9955 W. 20TH Ave
Lakewood, CO 80215
Mailing address
9955 W. 20TH Ave
Lakewood, CO 80215
Phone (303) 986-0865
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 |
|---|---|---|---|
| 021432 | CO | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266883200000",
"number": "1700108461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9955 W. 20TH AVE",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "80215",
"telephone_number": "303-986-0865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9955 W. 20TH AVE",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "80215",
"telephone_number": "303-986-0865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DIANNE",
"middle_name": "K.",
"name_prefix": "Mrs.",
"credential": "CERTIFIED MASSAGE TH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-23",
"last_updated": "2010-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "CO",
"license": "021432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.