Alice M Clark, MA, LPC, CACIII

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1687 Issued in CO

Practice address

5377 Manhattan Cir
Suite 200
Boulder, CO 80303-4333

Phone

(303) 263-7855

NPI assigned

Aug 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1760495329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 YAUPON AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044364",
            "telephone_number": "303-263-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5377 MANHATTAN CIR",
            "address_2": "SUITE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034333",
            "telephone_number": "303-263-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ALICE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MA, LPC, CACIII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "5499",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "1687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelo Anthony Ciliberti II, MA, LPC, CGP
• Ashley M Ciraco
• CK Leasing, LLC
• Claimsbpo LLC
• Kyrstin Clare, LSW
• Christy Lynn Clark, M.A. LPC
• Deborah Clark I
• Denise Maureen Clark, N.D.
• Gary Bruce Clark, MD
• James Emit Clark, MD

• Professional Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.