Individual provider Active NPI

Amy Joan Alsum, MSW, LCSW

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1083882898
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.00992121 Issued in CO
Practice address
4112 Outlook Blvd Ste 96
Pueblo, CO 81008-1667
Phone
(719) 776-6850
Fax
(719) 776-6855
NPI assigned
Feb 14, 2008
Last updated
May 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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.00992121 CO Primary

Addresses

Primary practice location

4112 Outlook Blvd Ste 96
Pueblo, CO 81008-1667

Mailing address

PO Box 911057
Denver, CO 80291-1057
Phone (888) 269-7001

Other practice location 1

2925 Professional Pl Ste 101
Colorado Springs, CO 80904-8125
Phone (719) 776-6850

Other names 1

  • Amy Joan Bruinooge Former name

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pikaart Enterprises, Inc Past Accepting new patients

Organizations & group practices 1

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": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1083882898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911057",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911057",
            "telephone_number": "888-269-7001",
            "fax_number": "303-764-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD STE 96",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-776-6850",
            "fax_number": "719-776-6855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Professional Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809048125",
            "country_code": "US",
            "telephone_number": "719-776-6850",
            "fax_number": "719-776-6855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALSUM",
        "first_name": "AMY",
        "middle_name": "JOAN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.00992121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "BRUINOOGE",
            "middle_name": "JOAN",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.