Individual provider Active NPI

Colette C Rosquist, LCSW

  • Clinical Social Worker
  • Grand Junction, CO
National Provider Identifier
1245565795
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1997 Issued in CO
Practice address
515 28 3/4 Rd
Grand Junction, CO 81501-5016
Phone
(970) 263-4918
Fax
(970) 683-7278
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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 1997 CO Primary

Addresses

Primary practice location

515 28 3/4 Rd
Grand Junction, CO 81501-5016

Mailing address

715 Horizon Dr Ste 225
Grand Junction, CO 81506-8743

Other names 1

  • Colette C Zolg Former name

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
I20120105000322 CO Practitioner - Clinical Social Worker 2163698689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1997COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Feb 3, 2021 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

6975 S Union Park Ctr
Ste 600
Midvale, UT 84047
Phone (385) 255-7859

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1245565795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 HORIZON DR STE 225",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 28 3/4 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815015016",
            "telephone_number": "970-263-4918",
            "fax_number": "970-683-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSQUIST",
        "first_name": "COLETTE",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLETTE",
            "last_name": "ZOLG",
            "middle_name": "C",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.