Individual provider Active NPI

Quenisha S Lane, LCSW, MSW

  • Clinical Social Worker
  • Broomfield, CO
National Provider Identifier
1093484370
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09930708 Issued in CO
Practice address
3303 W 144TH Ave Unit 204
Broomfield, CO 80023-9601
Phone
(720) 709-2810
NPI assigned
Sep 9, 2021
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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.09930708 CO Primary

Addresses

Primary practice location

3303 W 144TH Ave Unit 204
Broomfield, CO 80023-9601

Mailing address

3303 W 144TH Ave Unit 204
Broomfield, CO 80023-9601

Other practice location 1

1455 Dixon Ave
Lafayette, CO 80026-8879
Phone (504) 722-7535

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
I20250128000198 CO Practitioner - Clinical Social Worker 2062941628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ThornwoodwellnessllcGroup PAC ID 4284094137, 17 clinicians

Practice addresses (Care Compare)

3303 W 144TH Ave
Unit 204
Broomfield, CO 80023-9601
Phone (720) 709-2810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09930708COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thornwoodwellnessllc Clinical Current Accepting new patients
Thornwoodwellnessllc CurrentSince Dec 1, 2024 Accepting new patients
Thornwoodwellnessllc CurrentSince Dec 1, 2024 Accepting new patients

Locations

3303 W 144th Ave
Unit 204
Broomfield, CO 80023
Phone (720) 709-2810

1721 N High St
Denver, CO 80218
Phone (303) 908-5560

225 W South Boulder Rd
Ste 103
Louisville, CO 80027
Phone (720) 709-2810

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, 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": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1093484370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 W 144TH AVE UNIT 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 W 144TH AVE UNIT 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239601",
            "telephone_number": "720-709-2810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 Dixon Ave",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800268879",
            "country_code": "US",
            "telephone_number": "504-722-7535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "QUENISHA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LCSW, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09930708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.