Individual provider Active NPI

Maria Velasco, LCSW

  • Clinical Social Worker
  • Cheyenne, WY
National Provider Identifier
1154947562
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-1718 Issued in WY
Practice address
2617 E Lincolnway Ste G
Cheyenne, WY 82001-5671
Phone
(307) 286-0921
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 LCSW-1718 WY Primary

Addresses

Primary practice location

2617 E Lincolnway Ste G
Cheyenne, WY 82001-5671

Mailing address

2617 E Lincolnway Ste G
Cheyenne, WY 82001-5671
Phone (307) 286-0921

Other identifiers 1

IdentifierTypeStateIssuer
156171500MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250925002070 WY Practitioner - Clinical Social Worker 3779088273 Reassigns benefits to 1 organization
I20250927000157 CO Practitioner - Clinical Social Worker 3779088273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1301 Riverside Ave
Fort Collins, CO 80524-4374
Phone (970) 888-4070

2500 Dell Range Blvd
Cheyenne, WY 82009-5273
Phone (307) 630-4729

620 Iris Dr
Sterling, CO 80751-4716
Phone (970) 522-7266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-1718WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Liv in-Home Counseling & Care Management, LLC Clinical CurrentSince Aug 30, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 9, 2026 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 9, 2026 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1301 Riverside Ave
Fort Collins, CO 80524
Phone (970) 482-3680

620 Iris Dr
Sterling, CO 80751
Phone (970) 313-2740

2500 Dell Range Blvd
Cheyenne, WY 82009
Phone (307) 630-4729

Organizations & group practices 3

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": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1154947562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 E LINCOLNWAY STE G",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015671",
            "telephone_number": "307-286-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 E LINCOLNWAY STE G",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015671",
            "telephone_number": "307-286-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "MARIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-1718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156171500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.