Individual provider Active NPI

Jolene Frances Conway Clatterbuck, MA

  • Mental Health Counselor
  • Arvada, CO
National Provider Identifier
1760650303
Registry record updated Oct 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6171 Issued in CO
Practice address
6036 Urban St
Arvada, CO 80004-4123
Phone
(651) 216-0098
NPI assigned
Feb 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6171 CO Primary

Addresses

Primary practice location

6036 Urban St
Arvada, CO 80004-4123

Mailing address

6036 Urban St
Arvada, CO 80004-4123
Phone (651) 216-0098

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6171COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667001600000",
    "number": "1760650303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6036 URBAN ST",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044123",
            "telephone_number": "651-216-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6036 URBAN ST",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044123",
            "telephone_number": "651-216-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY CLATTERBUCK",
        "first_name": "JOLENE",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-18",
        "last_updated": "2022-10-29",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "6171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2022; 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.