Individual provider Active NPI

Jeffrey Nelson, LCSW

  • Mental Health Counselor
  • Lakewood, CO
National Provider Identifier
1104945781
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW-992452 Issued in CO
Practice address
421 Zang St
Lakewood, CO 80228-1052
Phone
(303) 989-4357
Fax
(303) 988-2017
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW-992452 CO Primary

Addresses

Primary practice location

421 Zang St
Lakewood, CO 80228-1052

Mailing address

421 Zang St
Lakewood, CO 80228-1052
Phone (303) 989-4357

Other identifiers 1

IdentifierTypeStateIssuer
98275054MedicaidCO

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
I20070918000594 CO Practitioner - Clinical Social Worker 8820182173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westside Behavioral Care, Inc.Group PAC ID 8426031774, 13 clinicians

Practice addresses (Care Compare)

950 Wadsworth Blvd
Suite 202
Lakewood, CO 80214-4542
Phone (303) 986-4197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-992452COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Behavioral Care, Inc. Clinical CurrentSince May 9, 2024 Accepting new patients

Locations

950 Wadsworth Blvd
Ste 202
Lakewood, CO 80214
Phone (303) 257-7047

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1104945781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 ZANG ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281052",
            "telephone_number": "303-989-4357",
            "fax_number": "303-988-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 ZANG ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281052",
            "telephone_number": "303-989-4357",
            "fax_number": "303-988-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JEFFREY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LCSW-992452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98275054",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.