Individual provider Active NPI

Joanna Ioannides, MSW/LCSW

  • Psychologist
  • Aurora, CO
National Provider Identifier
1285639567
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
6105 S Main St Ste 219
Aurora, CO 80016-5361
Phone
(720) 319-7319
Fax
(303) 379-4607
NPI assigned
Jun 14, 2005
Last updated
Sep 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary
Clinical Social Worker 1041C0700X 992674 CO

Addresses

Primary practice location

6105 S Main St Ste 219
Aurora, CO 80016-5361

Mailing address

6105 S Main St Ste 219
Aurora, CO 80016-5361
Phone (720) 319-7319

Other practice location 1

2401 S Downing St
Denver, CO 80210-5811
Phone (720) 319-7319

Other identifiers 2

IdentifierTypeStateIssuer
1114379112OtherCOGROUP NPI
08105031MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2025 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
992674COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boulderwise Counseling, LLC Current Accepting new patients
Concepts Counseling and Psychotherapy Psychologist CurrentSince Sep 10, 2023 Accepting new patients
Lowry Counseling LLC Clinical PastSince Sep 24, 2023 Accepting new patients

Locations

6105 S Main St
Ste 219
Aurora, CO 80016
Phone (720) 319-7319

2401 S Downing St
Denver, CO 80210
Phone (303) 733-2727

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1285639567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 S MAIN ST STE 219",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165361",
            "telephone_number": "720-319-7319",
            "fax_number": "303-379-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 S MAIN ST STE 219",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165361",
            "telephone_number": "720-319-7319",
            "fax_number": "303-379-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S Downing St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802105811",
            "country_code": "US",
            "telephone_number": "720-319-7319",
            "fax_number": "303-379-4607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IOANNIDES",
        "first_name": "JOANNA",
        "name_prefix": "Ms.",
        "credential": "MSW/LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2023-09-08",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "992674",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1114379112",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08105031",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.