Individual provider Active NPI

Charlotte W Krasnoff, LCSW

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1164532933
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
876197 Issued in CO
Practice address
1990 Kalmia
Boulder, CO 80304-1925
Phone
(303) 442-8414
Fax
(303) 417-0712
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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 876197 CO Primary

Addresses

Primary practice location

1990 Kalmia
Boulder, CO 80304-1925

Mailing address

1990 Kalmia Ave
Boulder, CO 80304-1925
Phone (303) 442-8414

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
I20100111000185 CO Practitioner - Clinical Social Worker 5597806786 Practice locations: Boulder, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1990 Kalmia Ave
Boulder, CO 80304-1925
Phone (303) 442-8414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
876197COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1164532933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 KALMIA AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803041925",
            "telephone_number": "303-442-8414",
            "fax_number": "303-417-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 KALMIA",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803041925",
            "telephone_number": "303-442-8414",
            "fax_number": "303-417-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNOFF",
        "first_name": "CHARLOTTE",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "876197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.