Individual provider Active NPI

Amie Rebecca Podolsky, LSW

  • Clinical Social Worker
  • Durango, CO
National Provider Identifier
1093909327
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW-1118 Issued in CO
Practice address
543 Animas View Dr Apt 23
Durango, CO 81301-8922
Phone
(970) 946-8004
NPI assigned
Aug 29, 2007
Last updated
Jan 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 7150 CO
Clinical Social Worker 1041C0700X CSW-1118 CO Primary

Addresses

Primary practice location

543 Animas View Dr Apt 23
Durango, CO 81301-8922

Mailing address

543 Animas View Dr., #23
Durango, CO 81303-3409
Phone (970) 946-8004

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
7150COMDAddiction (Substance Use Disorder) Counselor
CSW-1118COMDClinical Social Worker
1118COMDOther Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1093909327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 ANIMAS VIEW DR., #23",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813033409",
            "telephone_number": "970-946-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 ANIMAS VIEW DR APT 23",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018922",
            "telephone_number": "970-946-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODOLSKY",
        "first_name": "AMIE",
        "middle_name": "REBECCA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "7150",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW-1118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.