Individual provider Active NPI

Taralee Wright Birkenstock, LCSW

  • Clinical Social Worker
  • Fort Collins, CO
National Provider Identifier
1093286189
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3351 Eastbrook Dr Ste 200
Fort Collins, CO 80525-5744
Phone
(970) 500-0164
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 09929934 CO
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

3351 Eastbrook Dr Ste 200
Fort Collins, CO 80525-5744

Mailing address

1650 S Topaz Way
Meridian, ID 83642-4474
Phone (208) 605-7070

Other names 1

  • Taralee Janen Wright Former name

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
I20231221002173 CO Practitioner - Clinical Social Worker 8628428372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

2860 S Circle Dr
Colorado Springs, CO 80906-4195
Phone (719) 540-2100

3351 Eastbrook Dr
Suite 200
Fort Collins, CO 80525-5744
Phone (888) 374-5066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09929934COMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Dec 1, 2023 Accepting new patients
Family Care Center, LLC CurrentSince Dec 1, 2023 Accepting new patients
Center for Autism and Related Disorders LLC PastSince Nov 8, 2020 Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

3351 Eastbrook Dr
Ste 200
Fort Collins, CO 80525
Phone (970) 500-0164

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1093286189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S TOPAZ WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424474",
            "telephone_number": "208-605-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 EASTBROOK DR STE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255744",
            "telephone_number": "970-500-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRKENSTOCK",
        "first_name": "TARALEE",
        "middle_name": "WRIGHT",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "09929934",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARALEE",
            "last_name": "WRIGHT",
            "middle_name": "JANEN",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.