Individual provider Active NPI

Karly Bzalel, LCSW

  • Clinical Social Worker
  • Canon City, CO
National Provider Identifier
1063115541
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09929132 Issued in CO
Practice address
3225 Independence Rd
Canon City, CO 81212-9380
Phone
(719) 275-2351
NPI assigned
Mar 23, 2023
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 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.09929132 CO Primary

Addresses

Primary practice location

3225 Independence Rd
Canon City, CO 81212-9380

Mailing address

3225 Independence Rd
Canon City, CO 81212-9380
Phone (719) 275-2351

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
I20241223002863 CO Practitioner - Clinical Social Worker 3173050515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

111 Vesta Rd
Salida, CO 81201-9327
Phone (719) 539-6502

3225 Independence Rd
Canon City, CO 81212-9380
Phone (719) 275-2351

511 Main St
Westcliffe, CO 81252-8309
Phone (719) 783-0566

714 Front St
Leadville, CO 80461-3921
Phone (719) 486-0985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09929132COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Mental Health Center, Inc. Current Accepting new patients
West Central Mental Health Center, Inc. CurrentSince Dec 9, 2024 Accepting new patients
West Central Mental Health Center Inc. CurrentSince Dec 9, 2024 Accepting new patients
Behavioral Health Response, Inc PastSince May 28, 2023 Accepting new patients

Locations

3225 Independence Rd
Canon City, CO 81212
Phone (719) 275-2351

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1063115541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 INDEPENDENCE RD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129380",
            "telephone_number": "719-275-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 INDEPENDENCE RD",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129380",
            "telephone_number": "719-275-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BZALEL",
        "first_name": "KARLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09929132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.