Boulder Wellness Counseling, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BOULDER WELLNESS COUNSELING, PLLC

Practice address

6525 Gunpark Dr Ste 370-274
Boulder, CO 80301-3346

Phone

(720) 432-7787

NPI assigned

Feb 7, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Laura Kathleen Baxter, LCSW, LACNPI 1790181972

Title

Owner

Phone

(402) 990-8287

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Baxter, LCSW, LAC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1790181972
  NPD Authorized official

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1932853181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 GUNPARK DR STE 370-274",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013346",
            "telephone_number": "720-432-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 GUNPARK DR STE 370-274",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013346",
            "telephone_number": "720-432-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER WELLNESS COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-990-8287",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, LAC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Deanna Marie Bourgeois, OTD, OTR/L

• Mental Health Clinic/Center (Including Community Mental Health Center) in Boulder, CO
• Providers in Boulder, CO by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.