Lisa Evensky-Stark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.00000790 Issued in CO

Practice address

1400 E Boulder St
Colorado Springs, CO 80909-5533

Phone

(719) 365-5221

NPI assigned

Jun 15, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442
  Medicare reassignment Care Compare group NPD
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1356722417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-365-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4860 Robb St",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Wheat Ridge",
            "state": "CO",
            "postal_code": "800332184",
            "country_code": "US",
            "telephone_number": "303-278-7418",
            "fax_number": "303-223-9315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVENSKY-STARK",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.00000790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13578082",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "CSW.00000790",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanner Evans
• Amanda N Evanson, RBT
• William Albert Eveland III, D.M.D.
• Elora A Even
• Michele Marie Even, RN, MSN
• Evenstar Internal Medicine PC
• Ever Evolving Counseling
• Evercare Medequip LLC
• Rachel Everett, B.A.
• Ralph E. Everett, M.D.

• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.