Individual provider Active NPI

Adeline Deborah Armijo, LCSW

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1275744096
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
989979 Issued in CO
Practice address
503 N Main St
Ste 326
Pueblo, CO 81003-3130
Phone
(480) 209-8137
Fax
(719) 564-5605
NPI assigned
May 24, 2007
Last updated
Apr 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 989979 CO Primary
Registered Nurse 163W00000X 52649 CO

Addresses

Primary practice location

503 N Main St
Ste 326
Pueblo, CO 81003-3130

Mailing address

7 Encino PL
Pueblo, CO 81005-2948
Phone (719) 561-9084

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
I20080521000231 CO Practitioner - Clinical Social Worker 7214006998 Practice locations: Pueblo, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

503 N Main St
Pueblo, CO 81003-3139
Phone (719) 561-9084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52649COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Associates for Psychotherapy and Education, PC PastSince Jan 1, 1993 Accepting new patients
Arkansas Peak Psychological Services, PPLC Past Accepting new patients
Southwest Wellness & Life Enhancement Center Clinical Past Accepting new patients

Organizations & group practices 3

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1275744096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ENCINO PL",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052948",
            "telephone_number": "719-561-9084",
            "fax_number": "719-564-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N MAIN ST",
            "address_2": "STE 326",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033130",
            "telephone_number": "480-209-8137",
            "fax_number": "719-564-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMIJO",
        "first_name": "ADELINE",
        "middle_name": "DEBORAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "989979",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "52649",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.