Active NPI
John Harold Jorgensen, LCSW
- Clinical Social Worker
- Colorado Springs, CO
National Provider Identifier
1033104740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 991975
- Practice address
- 313 N Tejon St
Colorado Springs, CO 80903-1243 - Phone
- (719) 629-6406
- NPI assigned
- Sep 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 | 991975 | CO | Primary |
Addresses
Primary practice location
313 N Tejon St
Colorado Springs, CO 80903-1243
Mailing address
15894 Kansas Pacific Court
Monument, CO 80132-2502
Phone (719) 629-6406
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 991975 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487030400000",
"number": "1033104740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15894 KANSAS PACIFIC COURT",
"city": "MONUMENT",
"state": "CO",
"postal_code": "801322502",
"telephone_number": "719-629-6406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 N TEJON ST",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809031243",
"telephone_number": "719-629-6406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGENSEN",
"first_name": "JOHN",
"middle_name": "HAROLD",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2017-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "991975",
"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 Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.