Jutharat McCormack, LPC, RN, CAC III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

7138 Issued in CO

Practice address

2610 Stout St
Denver, CO 80205-2941

Phone

(303) 504-1200

NPI assigned

Jun 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1720282155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 STOUT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052941",
            "telephone_number": "720-341-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 STOUT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052941",
            "telephone_number": "303-504-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "JUTHARAT",
        "name_prefix": "Ms.",
        "credential": "LPC, RN, CAC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "162465",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "6391",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "7138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parker Young McConnell Sr.
• Susan Lynn McConnell
• Amanda McCorkel
• Kristine Marie McCorkle, PT
• Ellen McCormack, MD
• Katelynn McCormack, PHARMD
• McCormick Speech Therapy, LLC
• Bradley Paul McCormick
• Brandon Foster McCormick
• Deborah Ann McCormick, RN

• Addiction (Substance Use Disorder) Counselor in Denver, CO
• Providers in Denver, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.