Individual provider Active NPI

Christine Sanyu Ogolla, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1205693785
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09930077 Issued in CO
Practice address
5376 Tomah Dr Ste 200
Colorado Springs, CO 80918-6968
Phone
(719) 401-1851
NPI assigned
Mar 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 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.09930077 CO Primary

Addresses

Primary practice location

5376 Tomah Dr Ste 200
Colorado Springs, CO 80918-6968

Mailing address

419 Quebec St
Colorado Springs, CO 80911-2331

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
I20260417003389 CO Practitioner - Clinical Social Worker 6103392030 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

Practice addresses (Care Compare)

2960 N Circle Dr
Suite 200
Colorado Springs, CO 80909-1163

5687 Sunshade PT
Colorado Springs, CO 80923-7570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09930077COMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1205693785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 QUEBEC ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809112331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5376 TOMAH DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809186968",
            "telephone_number": "719-401-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGOLLA",
        "first_name": "CHRISTINE",
        "middle_name": "SANYU",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09930077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.