Soul Dogs Inc Group Practice

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SOUL DOGS INC GROUP PRACTICE

Practice address

5005 W 81St PL Unit 201
Westminster, CO 80031-4380

Phone

(303) 250-2785

NPI assigned

Jan 27, 2022

Organization subpart

Yes

Parent organization

SOUL DOGS INCAs reported in NPPES

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

Authorized official

Name

Christian Anderson, PHD ACSW LCSW

Title

Executive Director

Phone

(303) 250-2785

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 1

Part of

Soul Dogs Inc

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Soul Dogs Inc

  • Voluntary or Charitable Agency
  • Westminster, CO
  • NPI 1851946099
  NPPES parent name

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1114670478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 W 81ST PL UNIT 201",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800314380",
            "telephone_number": "303-250-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 W 81ST PL UNIT 201",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800314380",
            "telephone_number": "303-250-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL DOGS INC GROUP PRACTICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUL DOGS INC",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "303-250-2785",
        "authorized_official_credential": "PHD ACSW LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427454289",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851946099",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashley@soul-dogs-inc.org",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "encrypted email",
            "address_1": "5005 W 81st Pl Unit 201",
            "city": "Westminster",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800314380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Marissa Song, MA, LPCC
• Bernard J Sopky, M.D.
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• Spanish Interpreting of Colorado

• Clinical Social Worker in Westminster, CO
• Providers in Westminster, 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 Jan 27, 2022; 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.