Active NPI
Dustin Glenn Shivar, LCSW
- Clinical Social Worker
- Lakewood, CO
National Provider Identifier
1144479197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW.09924412
- Practice address
- 3595 S Teller St
Lakewood, CO 80235-2014 - Phone
- (303) 425-4950
- Fax
- (303) 432-5939
- NPI assigned
- Sep 15, 2008
- Last updated
- Jul 16, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Clinical Social Worker | 1041C0700X | CSW.09924412 | CO | Primary |
Addresses
Primary practice location
3595 S Teller St
Lakewood, CO 80235-2014
Mailing address
3595 S Teller St
Lakewood, CO 80235-2014
Phone (303) 425-4950
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Mobile Services | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Wheat Ridge, CO
- NPI 1154403798
-
- Psychologist
- Clayton, NC
- NPI 1689098774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626393600000",
"number": "1144479197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3595 S TELLER ST",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802352014",
"telephone_number": "303-425-4950",
"fax_number": "303-432-5939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3595 S TELLER ST",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802352014",
"telephone_number": "303-425-4950",
"fax_number": "303-432-5939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVAR",
"first_name": "DUSTIN",
"middle_name": "GLENN",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-15",
"last_updated": "2021-07-16",
"certification_date": "2021-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW.09924412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.