Individual provider Active NPI

Colleen Stegenga, MSW, LCSW, QMHP

  • Clinical Social Worker
  • Sioux Falls, SD
National Provider Identifier
1124561816
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3592 Issued in SD
Practice address
2000 S Summit Ave
Sioux Falls, SD 57105-2727
Phone
(605) 336-0510
Fax
(605) 336-3779
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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 3592 SD Primary

Addresses

Primary practice location

2000 S Summit Ave
Sioux Falls, SD 57105-2727

Mailing address

2000 S Summit Ave
Sioux Falls, SD 57105-2727
Phone (605) 336-0510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20190122000889 SD Practitioner - Clinical Social Worker 4587901152

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1500 S Sycamore Ave
Suite 102
Sioux Falls, SD 57110-3711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3592SDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Behavioral Healthcare Past Accepting new patients
Southeastern Behavioral Healthcare PastSince Dec 18, 2013 Accepting new patients

Organizations & group practices 2

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": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1124561816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S SUMMIT AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052727",
            "telephone_number": "605-336-0510",
            "fax_number": "605-336-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S SUMMIT AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052727",
            "telephone_number": "605-336-0510",
            "fax_number": "605-336-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEGENGA",
        "first_name": "COLLEEN",
        "credential": "MSW, LCSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "3592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.