Individual provider Active NPI

Cheryl Lynn Hernandez-Rutz, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1275159782
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09930493 Issued in CO
Practice address
4260 Vicksburg Ter
Colorado Springs, CO 80917-2314
Phone
(406) 598-5448
NPI assigned
Jun 20, 2020
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 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 WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW.09930493 CO Primary

Addresses

Primary practice location

4260 Vicksburg Ter
Colorado Springs, CO 80917-2314

Mailing address

4260 Vicksburg Ter
Colorado Springs, CO 80917-2314
Phone (406) 598-5448

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09930493COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Restoration Counseling, PLLC Clinical CurrentSince Aug 18, 2024 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.

NPI Registry JSON

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

{
    "created_epoch": "1592611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1275159782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 VICKSBURG TER",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809172314",
            "telephone_number": "406-598-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 VICKSBURG TER",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809172314",
            "telephone_number": "406-598-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-RUTZ",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-20",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09930493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.