Individual provider Active NPI

Annie Garcia, LCSW

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1093491169
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09928948 Issued in CO
Practice address
2118 Chatalet LN
Pueblo, CO 81005-4625
Phone
(720) 519-8487
Fax
(877) 345-3501
NPI assigned
Jun 23, 2023
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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.09928948 CO Primary

Addresses

Primary practice location

2118 Chatalet LN
Pueblo, CO 81005-4625

Mailing address

1 Kalisa Way Ste 101
Paramus, NJ 07652-3508
Phone (888) 948-6789

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
I20231005002660 CO Practitioner - Clinical Social Worker 6608221999 Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1093491169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KALISA WAY STE 101",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523508",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 CHATALET LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810054625",
            "telephone_number": "720-519-8487",
            "fax_number": "877-345-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "ANNIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.