Healthcare Provider Details

I. General information

NPI: 1013065374
Provider Name (Legal Business Name): JAMES SONGFIELD M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 03/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4570 SQUIRES CIR
BOULDER CO
80305-6702
US

IV. Provider business mailing address

4570 SQUIRES CIR
BOULDER CO
80305-6702
US

V. Phone/Fax

Practice location:
  • Phone: 303-241-1742
  • Fax:
Mailing address:
  • Phone: 303-241-1742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC4186
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4186
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: