Individual provider Active NPI

Melanie Virginia Wade

  • Clinical Social Worker
  • Grand Junction, CO
National Provider Identifier
1174240378
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09928603 Issued in CO
Practice address
1105B Colorado Ave
Grand Junction, CO 81501-3522
Phone
(970) 242-4400
NPI assigned
Oct 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 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 CSW.09928603 CO Primary

Addresses

Primary practice location

1105B Colorado Ave
Grand Junction, CO 81501-3522

Mailing address

884 Vineyard Ave
Palisade, CO 81526-6500
Phone (970) 270-9647

Other practice location 1

2470 Patterson Rd Ste 6
Grand Junction, CO 81505-1028
Phone (970) 462-7474

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
I20221208002800 CO Practitioner - Clinical Social Worker 0547639882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

720 S Colorado Blvd
PH North
Denver, CO 80246-1904
Phone (844) 843-7279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09928603COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hilltop Health Services Corporation Clinical CurrentSince Sep 8, 2024 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Nov 29, 2022 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

1105 Colorado Ave
#B
Grand Junction, CO 81501
Phone (970) 242-4400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1174240378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 VINEYARD AVE",
            "city": "PALISADE",
            "state": "CO",
            "postal_code": "815266500",
            "telephone_number": "970-270-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105B COLORADO AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815013522",
            "telephone_number": "970-242-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2470 Patterson Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815051028",
            "country_code": "US",
            "telephone_number": "970-462-7474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "MELANIE",
        "middle_name": "VIRGINIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.