Individual provider Active NPI

Eduardo Viezca, LSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1164145462
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW.0009924015 Issued in CO
Practice address
789 N Sherman St
Denver, CO 80203-3529
Phone
(720) 445-5858
NPI assigned
Sep 21, 2022
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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 LSW.0009924015 CO Primary

Addresses

Primary practice location

789 N Sherman St
Denver, CO 80203-3529

Mailing address

1354 W Nevada PL
Denver, CO 80223-2019
Phone (720) 445-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LSW.0009924015COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1164145462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1354 W NEVADA PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802232019",
            "telephone_number": "720-445-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 N SHERMAN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033529",
            "telephone_number": "720-445-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIEZCA",
        "first_name": "EDUARDO",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "LSW.0009924015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.