Annie Cecely Dornbush, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09924864 Issued in CO

Practice address

2505 23Rd St
Boulder, CO 80304

Phone

(415) 730-3991

NPI assigned

Aug 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1063606267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 23RD ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043705",
            "telephone_number": "415-730-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 23RD ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80304",
            "telephone_number": "415-730-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1348 10th Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941222304",
            "country_code": "US",
            "telephone_number": "415-564-2310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORNBUSH",
        "first_name": "ANNIE",
        "middle_name": "CECELY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "27422",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09924864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Eleanor Dooley, DC
• Faith Watson Doppelt
• Doree Baker-Newbery
• Todd Alan Dorfman, MD
• Marina Dorian, PHD
• Eric Peter Dorninger, N.D., LAC
• Justene Jane Dorr
• Kade Alan Dorsey
• Jennifer Davis Dossett, R.M.
• Veronica P Dotterweich, FNP

• Clinical Social Worker in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.