Individual provider Active NPI

Elizabeth Durham Floyde, LCSW

  • Clinical Social Worker
  • Salida, CO
National Provider Identifier
1104293224
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09924005 Issued in CO
Practice address
123 G St Ste 8
Salida, CO 81201-2030
Phone
(719) 717-9009
Fax
(719) 717-9009
NPI assigned
Aug 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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.09924005 CO Primary

Addresses

Primary practice location

123 G St Ste 8
Salida, CO 81201-2030

Mailing address

PO Box 1214
Poncha Springs, CO 81242-1001
Phone (719) 717-9009

Other practice location 1

107 La Plata Ave
PO Box 1214
Poncha Springs, CO 81242-1001
Phone (719) 717-9009

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
I20160130000001 CO Practitioner - Clinical Social Worker 8325341019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

107 La Plata St
Poncha Springs, CO 81242-5063
Phone (303) 808-9459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09924005COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connectivity Counseling, LLC. Clinical CurrentSince Aug 14, 2017 Accepting new patients

Locations

123 G St
Ste 8
Salida, CO 81201
Phone (719) 221-6937

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": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104293224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1214",
            "city": "PONCHA SPRINGS",
            "state": "CO",
            "postal_code": "812421001",
            "telephone_number": "719-717-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 G ST STE 8",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812012030",
            "telephone_number": "719-717-9009",
            "fax_number": "719-717-9009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 La Plata Ave",
            "address_2": "PO Box 1214",
            "address_purpose": "LOCATION",
            "city": "Poncha Springs",
            "state": "CO",
            "postal_code": "812421001",
            "country_code": "US",
            "telephone_number": "719-717-9009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLOYDE",
        "first_name": "ELIZABETH",
        "middle_name": "DURHAM",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09924005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salida, CO

Sources for this page

Verify at the official NPI Registry.