Individual provider Active NPI

Regina Kearney, LCSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1093065294
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09923709 Issued in CO
Practice address
4455 E 12TH Ave
Denver, CO 80220-2415
Phone
(303) 504-6500
Fax
(303) 504-7991
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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 09923709 CO Primary

Addresses

Primary practice location

4455 E 12TH Ave
Denver, CO 80220-2415

Mailing address

4455 E 12TH Ave
Denver, CO 80220-2415
Phone (303) 504-6500

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

State licenses

LicenseStateTypeSpecialty
09923709COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1093065294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "303-504-6500",
            "fax_number": "303-504-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "303-504-6500",
            "fax_number": "303-504-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "REGINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09923709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.