Healthcare Provider Details

I. General information

NPI: 1255099792
Provider Name (Legal Business Name): MATTHEW CLAUSEN MFTC, LPCC, MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 BROADWAY ST STE 102
BOULDER CO
80305-3300
US

IV. Provider business mailing address

PO BOX 3582
BOULDER CO
80307-3582
US

V. Phone/Fax

Practice location:
  • Phone: 303-335-9308
  • Fax:
Mailing address:
  • Phone: 303-335-9308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTC.0014501
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0020882
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: