Active NPI
Susan Rosewell-Jackson, PH.D.
- Professional Counselor
- Boulder, CO
National Provider Identifier
1851610034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 61
- Practice address
- 2322 20TH St
Boulder, CO 80304-4276 - Phone
- (303) 442-3888
- NPI assigned
- May 26, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 61 | CO | Primary |
Addresses
Primary practice location
2322 20TH St
Boulder, CO 80304-4276
Mailing address
2322 20TH St
Boulder, CO 80304-4276
Phone (303) 442-3888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61 | Other | CO | LICENSED PROFESSIONAL COUNSELOR |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61 | CO | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1851610034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2322 20TH ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803044276",
"telephone_number": "303-442-3888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2322 20TH ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803044276",
"telephone_number": "303-442-3888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEWELL-JACKSON",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-26",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "61",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED PROFESSIONAL COUNSELOR",
"identifier": "61",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.