Mary Lou Lubchenco, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

985029 Issued in CO

Practice address

219 E St Vrain Street
Colorado Springs, CO 80903

Phone

(719) 577-4775

Fax

(719) 577-9656

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary Lou Larimer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1104932987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 E ST VRAIN STREET",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80903",
            "telephone_number": "719-577-4775",
            "fax_number": "719-577-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E ST VRAIN STREET",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80903",
            "telephone_number": "719-577-4775",
            "fax_number": "719-577-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBCHENCO",
        "first_name": "MARY",
        "middle_name": "LOU",
        "name_prefix": "Ms.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "985029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07106750",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LARIMER",
            "middle_name": "LOU",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Loyals-Support-Services-LLC
• Lalana Lozano
• Brett T Lozon, DPT
• Kimberly Lu, DPT
• Henry Lua, MD
• Kendra Lubin
• Jessica Lubs, AGCNS
• Katarina Lucardie
• Larencia A Lucas Caine, AGNP-C
• Lucas Castillo PC

• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.