Active NPI
Charles Harry Wingfield, LCSW CACIII
- Social Worker
- Pueblo West, CO
National Provider Identifier
1174540009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 991320
- 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, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038715 | Medicaid | CO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2049 | CO | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associates for Psychotherapy and Education, PC | Past | 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.
-
- Group Psychotherapy Psychologist
- Pueblo, CO
- NPI 1356366132
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.