Individual provider Active NPI

Susanna C Mandics, MSW, LCSW

  • Clinical Social Worker
  • Thornton, CO
National Provider Identifier
1053474809
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09923087 Issued in CO
Practice address
8931 Huron St
Thornton, CO 80260-6806
Phone
(303) 853-3500
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW.09923087 CO Primary

Addresses

Primary practice location

8931 Huron St
Thornton, CO 80260-6806

Mailing address

1870 W 122ND Ave Ste 100
Westminster, CO 80234-2075
Phone (303) 853-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130306000017 CO Practitioner - Clinical Social Worker 8628223229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Reach Center, Inc CurrentSince Mar 11, 2024 Accepting new patients
Community Reach Center, Inc CurrentSince Mar 11, 2024 Accepting new patients

Locations

8931 Huron St
Thornton, CO 80260
Phone (303) 853-3433

1870 W 122nd Ave
Ste 100
Westminster, CO 80234
Phone (303) 853-3800

Interoperability endpoints

  • Direct secure messaging: susanna.mandics.p2@direct.communityreachcenter.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1053474809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W 122ND AVE STE 100",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342075",
            "telephone_number": "303-853-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 HURON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802606806",
            "telephone_number": "303-853-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDICS",
        "first_name": "SUSANNA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.