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JACK BLACKWELL
NPI 1417473190
Counselor - Mental Health in Boulder, CO

Active since August 15, 2017
2373 VINEYARD PL, BOULDER, CO 80304(720) 275-2756 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jul 21, 2022, Aug 15, 2017 (2 updates tracked since 2017).

About Jack Blackwell NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK BLACKWELL (NPI 1417473190) is an individual mental health provider in Boulder, Colorado, licensed in Colorado (NLC0103233) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1417473190
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJACK BLACKWELL
Location Address2373 VINEYARD PLBoulder, CO 80304-0649
Mailing Address2373 Vineyard PlBoulder, CO 80304-0649 · (720) 275-2756
Phone(720) 275-2756
Sole ProprietorYes
Enumeration DateAugust 15, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1417473190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CO · NLC0103233
2373 VINEYARD PL, Boulder, CO 80304
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Blackwell's NPI number?

The NPI number for Jack Blackwell is 1417473190. It was assigned to this individual provider in the NPPES registry on August 15, 2017.

Where is Jack Blackwell located?

Jack Blackwell practices at 2373 Vineyard Pl, Boulder, CO 80304. The listed phone number is (720) 275-2756.

What is Jack Blackwell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jack Blackwell was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.