Lucas Bryant Walljasper

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0020596 Issued in CO

Practice address

3320 13TH St
Boulder, CO 80304-2206

Phone

(414) 559-6930

NPI assigned

Aug 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1891414835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 13TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042206",
            "telephone_number": "414-559-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 13TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042206",
            "telephone_number": "414-559-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLJASPER",
        "first_name": "LUCAS",
        "middle_name": "BRYANT",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0020596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Alexandra Waller, LCSW
• Meredith Ann Waller, LCSW
• Ruth Stephanie Waller, P.T.
• Leah Wallerstein, M.A.
• Sean Wallis, NP
• Carol M Wallman
• Justin Brent Walmsley, LAC, MFTC
• Jennifer Walsh, RNC, MS, WHCNP
• Ari Philip Walter, MD
• Trudy P. Walter, MA LPC

• Mental Health Counselor in Boulder, CO
• Providers in Boulder, 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 May 23, 2023; 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.