Amber Ivanova, LCSW, LAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09925143 Issued in CO

Practice address

2525 13TH St Ste 200
Boulder, CO 80304-4104

Phone

(303) 449-6050

Fax

(720) 565-4132

NPI assigned

Mar 26, 2018

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amber.ivanova.p4@direct.clinicafamilyhealth.nextgenshare.com

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.

• Clinica Campesina Family Health Services

  • Clinic/Center
  • Lafayette, CO
  • NPI 1225025406
  Medicare reassignment NPD
• Metro Community Provider Network Inc

  • Federally Qualified Health Center (FQHC)
  • Aurora, CO
  • NPI 1558727883
  Medicare reassignment NPD
• Clinica Campesina Family Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longmont, CO
  • NPI 1558109223
  NPD
• Metro Community Provider Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Aurora, CO
  • NPI 1144489675
  NPD
• Metro Community Provider Network, Inc.

  • Community/Retail Pharmacy
  • Aurora, CO
  • NPI 1255591780
  NPD

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1063917862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 S PUBLIC RD STE 203",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267093",
            "telephone_number": "303-665-3036",
            "fax_number": "303-665-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 13TH ST STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044104",
            "telephone_number": "303-449-6050",
            "fax_number": "720-565-4132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1355 S Colorado Blvd Ste C-100",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802223305",
            "country_code": "US",
            "telephone_number": "720-588-0281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVANOVA",
        "first_name": "AMBER",
        "credential": "LCSW, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0000931",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amber.ivanova.p4@direct.clinicafamilyhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGen EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "2525 13th St Ste 200",
            "city": "Boulder",
            "state": "CO",
            "country_code": "US",
            "postal_code": "803044104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jean Berkey Israelson, O.D.
• Gustavo Luis Isuani, M.D.
• It'S Me Again
• Mariana Iurcovich, PSYCHOTHERAPIST
• Ivan J. Miller, PHD, Inc.
• Srinivas Iyengar, M.D.
• Maria Isabel Izawa, NBCMI #101196
• J K Hullett Incorporated
• J.C. Sleeper, LLC
• Sakinah Jaaber, MA

• 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 May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.