MR. PATRICK LEONARD JETER (NPI# 1487069357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487069357 |
| Entity Type | Individual |
| Full Name | MR. PATRICK LEONARD JETER |
| Credential | MA |
| Practice Address |
3450 Broadway St Boulder CO 80304-1899 |
| Mailing Address |
3450 Broadway St Boulder CO 80304-1824 |
| Practice Telephone | 3034411100 |
| Practice Fax Number | 3034411286 |
| Mailing Telephone | 3034411100 |
| Mailing Fax Number | 3034411286 |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | MA PSYCHOLOGY | CO | Behavioral Health & Social Service Providers |
| Street Address |
3450 BROADWAY ST |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-1899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346324530 | Samuel Widd Medford Jr. | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2006-10-24 |
| 1881002574 | Catherine Ruth Abel | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-26 |
| 1962819797 | Judith Anne Voorhees Brown | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-14 |
| 1134535420 | Michele Ryan | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-08 |
| 1558777144 | Paul Egan Jr. | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-03 |
| 1114333796 | Michael Mack | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-03 |
| 1124434774 | Natasha Stackhouse | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-03 |
| 1588070361 | James Mcmillan | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-01 |
| 1366857120 | Abby Hulser | Community/Behavioral Health | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-06-30 |
| 1477968469 | Karen Tracy | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121107 | Eric Remza | Counselor | 3434 47th St Ste 130, Boulder, CO 80301-1802 | 2020-10-12 |
| 1851905806 | Hilah Neisha Remaily | Counselor | 1610 Lee Hill Rd, Boulder, CO 80304-0881 | 2020-09-06 |
| 1326650409 | Charlotte Elizabeth Irving | Counselor | 3850 Paseo Del Prado Apt 9, Boulder, CO 80301-1547 | 2020-08-19 |
| 1750921425 | Chelsey A Langlinais | Counselor | 3025 Broadway St Apt 7, Boulder, CO 80304-3139 | 2020-01-10 |
| 1174170815 | Brian Kim LLC | Counselor | 3035 Oneal Pkwy Apt V15, Boulder, CO 80301-1421 | 2019-08-19 |
| 1164083150 | Rachael L Bonaiuto | Counselor | 1800 30th St Ste 218b, Boulder, CO 80301-1006 | 2019-06-21 |
| 1659840635 | Alexandra Jean Hawes | Counselor | 1015 Utica Ave, Boulder, CO 80304-0718 | 2018-11-19 |
| 1588142079 | James O'geary | Counselor | 2249 Willard Loop Dr 104 Ucb, Boulder, CO 80309-3218 | 2018-08-06 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1891210068 | Bridget Borsdorf | Counselor | 825 S Broadway St Ste 50, Boulder, CO 80305-5932 | 2017-08-09 |
| Find all providers in BOULDER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.