Ms Jacqueline Sue Vandenbovenkamp, MA-LPC-ATR is a medicare enrolled "Art Therapist" provider in Boulder, Colorado. Her current practice location is
4500 19th St, Lot 190, Boulder, Colorado. You can reach out to her office (for appointments etc.) via phone at
(303) 641-2718.
Ms Jacqueline Sue Vandenbovenkamp is licensed to practice in * (Not Available) (license number 05-132) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1659588101.
Healthcare Provider's Profile
| Full Name | Ms Jacqueline Sue Vandenbovenkamp |
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| Gender | Female |
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| Speciality | Art Therapist |
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| Location | 4500 19th St, Boulder, Colorado |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1659588101
- Provider Enumeration Date: 05/16/2007
- Last Update Date: 09/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 3173042389
- Enrollment ID: I20250521001159
Medical Identifiers
Medical identifiers for Ms Jacqueline Sue Vandenbovenkamp such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1659588101 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101Y00000X | Counselor | 3918 (Colorado) | Secondary |
| 221700000X | Art Therapist | 05-132 (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Jacqueline Sue Vandenbovenkamp allows following entities to bill medicare on her behalf.
| Entity Name | Empower Mental Health Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699462697 PECOS PAC ID: 0143768341 Enrollment ID: O20240820000294 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Jacqueline Sue Vandenbovenkamp is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Ms Jacqueline Sue Vandenbovenkamp, MA-LPC-ATR 4500 19th St, Lot 190, Boulder, CO 80304-0613 Ph: (303) 641-2718 | Ms Jacqueline Sue Vandenbovenkamp, MA-LPC-ATR 4500 19th St, Lot 190, Boulder, CO 80304-0613 Ph: (303) 641-2718 |
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