Individual provider Active NPI

Susan Garvin, LCSW

  • Clinical Social Worker
  • Windsor, CO
National Provider Identifier
1275804163
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1743 Issued in CO
Practice address
1300 Main St
Windsor, CO 80550-5989
Phone
(970) 674-3158
Fax
(970) 686-5118
NPI assigned
Jan 24, 2012
Last updated
Jan 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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 1743 CO Primary

Addresses

Primary practice location

1300 Main St
Windsor, CO 80550-5989

Mailing address

1300 Main St
Windsor, CO 80550-5989
Phone (970) 674-3158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: No
  • 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
I20120523000724 CO Practitioner - Clinical Social Worker 4486817749 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1743COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Jan 1, 2013 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Jan 1, 2013 Accepting new patients

Locations

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

1300 Main St
Windsor, CO 80550
Phone (970) 686-5645

Organizations & group practices 2

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": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1275804163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MAIN ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505989",
            "telephone_number": "970-674-3158",
            "fax_number": "970-686-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MAIN ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505989",
            "telephone_number": "970-674-3158",
            "fax_number": "970-686-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARVIN",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CO

Sources for this page

Verify at the official NPI Registry.