Individual provider Active NPI

Christy Rene Turner, LAC, LSW

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1245061639
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW.0009924406 Issued in CO
Practice address
1624 Bonforte Blvd Ste D
Pueblo, CO 81001-1680
Phone
(719) 320-6201
NPI assigned
Aug 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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 ACD.00022539 CO
Clinical Social Worker 1041C0700X LSW.0009924406 CO Primary

Addresses

Primary practice location

1624 Bonforte Blvd Ste D
Pueblo, CO 81001-1680

Mailing address

1147 Longwood Ave
Pueblo, CO 81004-1040
Phone (719) 423-9905

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
I20241021002994 CO Practitioner - Clinical Social Worker 3173055746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1624 Bonforte Blvd
Suite D
Pueblo, CO 81001-1680
Phone (719) 671-2546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD.00022539COMDAddiction (Substance Use Disorder) Counselor
LSW.0009924406COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Counseling Collective LLC Clinical CurrentSince Oct 1, 2024 Accepting new patients

Locations

1624 Bonforte Blvd
Ste D
Pueblo, CO 81001
Phone (719) 310-5228

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": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1245061639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 LONGWOOD AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041040",
            "telephone_number": "719-423-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 BONFORTE BLVD STE D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011680",
            "telephone_number": "719-320-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNER",
        "first_name": "CHRISTY",
        "middle_name": "RENE",
        "credential": "LAC, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.00022539",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "LSW.0009924406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.