Individual provider Active NPI

Scott Barton Dewalt, B.S.

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1306165469
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2611 W Colorado Ave FL 2
Colorado Springs, CO 80904-3076
Phone
(719) 494-4934
Fax
(719) 634-2563
NPI assigned
May 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2611 W Colorado Ave FL 2
Colorado Springs, CO 80904-3076

Mailing address

2611 W Colorado Ave FL 2
Colorado Springs, CO 80904-3076
Phone (719) 494-4934

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
I20210601000107 CO Practitioner - Clinical Social Worker 2567861255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

32 Manitou Ave
Manitou Springs, CO 80829-2425
Phone (719) 685-6473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince May 5, 2021 Accepting new patients
Boundless Compassion LLC Clinical CurrentSince Oct 14, 2024 Accepting new patients

Locations

2611 W Colorado Ave
Fl 2
Colorado Springs, CO 80904
Phone (719) 445-6770

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

32 Manitou Ave
Manitou Springs, CO 80829
Phone (719) 685-6473

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1306165469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 W COLORADO AVE FL 2",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809043076",
            "telephone_number": "719-494-4934",
            "fax_number": "719-634-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 W COLORADO AVE FL 2",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809043076",
            "telephone_number": "719-494-4934",
            "fax_number": "719-634-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWALT",
        "first_name": "SCOTT",
        "middle_name": "BARTON",
        "name_prefix": "Mr.",
        "credential": "B.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.