Individual provider Active NPI

Jennifer Stucka, LCSW

  • Clinical Social Worker
  • Durango, CO
National Provider Identifier
1194158451
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09923263 Issued in CO
Practice address
281 Sawyer Dr
Suite 100
Durango, CO 81303-3409
Phone
(970) 259-2162
Fax
(970) 247-5255
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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.09923263 CO Primary

Addresses

Primary practice location

281 Sawyer Dr
Suite 100
Durango, CO 81303-3409

Mailing address

281 Sawyer Dr
Suite 100
Durango, CO 81303-3409
Phone (970) 259-2162

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
CSW.09923263COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1194158451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 SAWYER DR",
            "address_2": "SUITE 100",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813033409",
            "telephone_number": "970-259-2162",
            "fax_number": "970-247-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 SAWYER DR",
            "address_2": "SUITE 100",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813033409",
            "telephone_number": "970-259-2162",
            "fax_number": "970-247-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKA",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.