Active NPI
Gary Dwayne West, MSW, LCSW, BCD
- Clinical Social Worker
- Colorado Springs, CO
National Provider Identifier
1013138320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 876330
- Practice address
- 2965 Broadmoor Valley Rd
Ste B
Colorado Springs, CO 80906-4406 - Phone
- (719) 576-6617
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 876330 | CO | Primary |
Addresses
Primary practice location
2965 Broadmoor Valley Rd
Ste B
Colorado Springs, CO 80906-4406
Mailing address
2965 Broadmoor Valley Rd
Ste B
Colorado Springs, CO 80906-4406
Phone (719) 576-6617
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 876330 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531958400000",
"number": "1013138320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2965 BROADMOOR VALLEY RD",
"address_2": "STE B",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809064406",
"telephone_number": "719-576-6617",
"fax_number": "719-579-9792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2965 BROADMOOR VALLEY RD",
"address_2": "STE B",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809064406",
"telephone_number": "719-576-6617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEST",
"first_name": "GARY",
"middle_name": "DWAYNE",
"name_prefix": "Mr.",
"credential": "MSW, LCSW, BCD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2018-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "876330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.