Individual provider Active NPI

Clyde S Altum, M.A., LPC, CACII

  • Professional Counselor
  • Aurora, CO
National Provider Identifier
1770814758
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9681 Issued in CO
Practice address
2101 S Blackhawk St Ste 160
Aurora, CO 80014-1476
Phone
(720) 297-2063
NPI assigned
Jan 14, 2010
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 9681 CO Primary

Addresses

Primary practice location

2101 S Blackhawk St Ste 160
Aurora, CO 80014-1476

Mailing address

3287 95TH St
Boulder, CO 80301-4935
Phone (720) 297-2063

Other practice location 1

3287 95th St
Boulder, CO 80301-4935
Phone (720) 297-7063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260601003390 CO Practitioner - Mental Health Counselor 5496225377 Practice locations: Boulder, CO

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3287 95TH St
Boulder, CO 80301-4935
Phone (720) 297-7063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
9681COMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1770814758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3287 95TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803014935",
            "telephone_number": "720-297-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S BLACKHAWK ST STE 160",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141476",
            "telephone_number": "720-297-2063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3287 95th St",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803014935",
            "country_code": "US",
            "telephone_number": "720-297-7063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTUM",
        "first_name": "CLYDE",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.A., LPC, CACII",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-14",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "9681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.