Individual provider Active NPI

Kayla M Bettis-Weber, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1144549601
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1974 Issued in CO
Practice address
212 E Monument St
Colorado Springs, CO 80903-1004
Phone
(719) 447-0370
Fax
(719) 447-0371
NPI assigned
May 24, 2010
Last updated
Dec 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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 1974 CO Primary

Addresses

Primary practice location

212 E Monument St
Colorado Springs, CO 80903-1004

Mailing address

212 E Monument St
Colorado Springs, CO 80903-1004
Phone (719) 447-0370

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
I20140117001216 CO Practitioner - Clinical Social Worker 6103010756 Practice locations: Lakewood, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1785 Kipling St
Lakewood, CO 80215-2843
Phone (720) 729-7591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1974COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Dermatology Associates PLLC PastSince Oct 1, 2001 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1144549601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E MONUMENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031004",
            "telephone_number": "719-447-0370",
            "fax_number": "719-447-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E MONUMENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031004",
            "telephone_number": "719-447-0370",
            "fax_number": "719-447-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTIS-WEBER",
        "first_name": "KAYLA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.