Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Blackwell

Individual provider Mental Health Counselor · NPI 1417473190

Jack Blackwell is a Mental Health Counselor in Boulder, Colorado. Practices as a sole proprietor. Licensed in Colorado.

Licensed in
CO
In the registry since
2017

Practice location Address checks out

2373 Vineyard Pl
Boulder, CO 80304-0649
Phone: (720) 275-2756
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence NLC0103233 (CO)

Record details

NPI number1417473190
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 15, 2017
Last updated in NPPESJuly 21, 2022
Mailing address2373 Vineyard Pl, Boulder, CO 80304-0649

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