Jennifer Nicole Douglas

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC.0012246 Issued in CO

Practice address

1455 Dixon Ave
Lafayette, CO 80026-8879

Phone

(303) 443-8500

NPI assigned

Aug 30, 2011

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinica Campesina Family Health Services

  • Clinic/Center
  • Lafayette, CO
  • NPI 1225025406
  Medicare reassignment NPD
• Lighthouse Mental Wellness

  • Public Health or Welfare Agency
  • Aurora, CO
  • NPI 1134749476
  NPD Authorized official
• Clinica Campesina Family Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lafayette, CO
  • NPI 1184460321
  NPD
• Clinica Campesina Family Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longmont, CO
  • NPI 1558109223
  NPD

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1881975225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 DIXON AVE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268879",
            "telephone_number": "303-443-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 DIXON AVE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268879",
            "telephone_number": "303-443-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8931 Huron St",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802606806",
            "country_code": "US",
            "telephone_number": "303-853-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0012246",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Teresa Doherty, L.AC.
• Mindy Dolleman Carpenter, DC
• Caitlyn Carey Donegan, PT, DPT
• Janell Elaine Dorenkamp, RN
• Douglas K Pratt, MSW
• Shannon Campbell Dow, LSW
• Mary B Dowd
• Susan Bernice Dowdy, M.D.
• Dr. Sunda Friedman Tebockhorst Psychologicl Services, LTD
• Dr. Sunda Friedman Tebockhorst Psychologicl Services, LTD

• Mental Health Counselor in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.