Individual provider Active NPI

Charles Harry Wingfield, LCSW CACIII

  • Social Worker
  • Pueblo West, CO
National Provider Identifier
1174540009
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
991320 Issued in CO
Practice address
44 E Spaulding Ave
Ste 4
Pueblo West, CO 81007-1668
Phone
(719) 564-9039
Fax
(719) 561-8752
NPI assigned
Jul 16, 2006
Last updated
Aug 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2049 CO
Social Worker 104100000X 991320 CO Primary

Addresses

Primary practice location

44 E Spaulding Ave
Ste 4
Pueblo West, CO 81007-1668

Mailing address

44 E Spaulding Ave
Ste 4
Pueblo West, CO 81007-1668
Phone (719) 251-0398

Other identifiers 1

IdentifierTypeStateIssuer
038715MedicaidCO

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2049COMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Associates for Psychotherapy and Education, PC PastSince Jan 1, 1993 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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1174540009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 E SPAULDING AVE",
            "address_2": "STE 4",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810071668",
            "telephone_number": "719-251-0398",
            "fax_number": "719-547-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 E SPAULDING AVE",
            "address_2": "STE 4",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810071668",
            "telephone_number": "719-564-9039",
            "fax_number": "719-561-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGFIELD",
        "first_name": "CHARLES",
        "middle_name": "HARRY",
        "credential": "LCSW  CACIII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "2049",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "991320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038715",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo West, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.