Individual provider Active NPI

Siri Austill

  • Clinical Social Worker
  • Greeley, CO
National Provider Identifier
1104201185
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1300 N 17TH Ave
Greeley, CO 80631-9584
Phone
(970) 347-2120
NPI assigned
Jul 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1300 N 17TH Ave
Greeley, CO 80631-9584

Mailing address

2512 Spruce Dr
Loveland, CO 80538-3243
Phone (970) 691-9252

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
I20211230000075 CO Practitioner - Clinical Social Worker 8426449497 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Dec 22, 2021 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

Organizations & group practices 1

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": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1104201185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 SPRUCE DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805383243",
            "telephone_number": "970-691-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319584",
            "telephone_number": "970-347-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTILL",
        "first_name": "SIRI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.