NPIMap

Organization Active NPI

Sample Services

  • Clinical Social Worker
  • Fort Collins, CO
National Provider Identifier
1316817752
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SAMPLE SERVICES
Practice address
4007 Automation Way
Fort Collins, CO 80525-3479
Phone
(720) 684-6309
NPI assigned
Nov 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
Carmen Louise Sample
Title
Owner
Phone
(303) 523-8057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4007 Automation Way
Fort Collins, CO 80525-3479

Mailing address

606 Mountain View Ave
Longmont, CO 80501-2779
Phone (720) 684-6309

National Provider Directory

National Provider Directory
Tax ID family
Sample Services6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1316817752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012779",
            "telephone_number": "720-684-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 AUTOMATION WAY",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253479",
            "telephone_number": "720-684-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMPLE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "SAMPLE",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-523-8057"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.