Individual provider Active NPI

Lisa Yordy, LCSW

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1366807117
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09923981 Issued in CO
Practice address
6525 Gunpark Dr Ste 370-206
Boulder, CO 80301-3346
Phone
(303) 475-4755
NPI assigned
Dec 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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 09923981 CO Primary

Addresses

Primary practice location

6525 Gunpark Dr Ste 370-206
Boulder, CO 80301-3346

Mailing address

6525 Gunpark Dr Ste 370-206
Boulder, CO 80301-3346
Phone (303) 475-4755

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
I20180720002061 CO Practitioner - Clinical Social Worker 2264789304 Practice locations: Boulder, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6525 Gunpark Dr
Suite 370 206
Boulder, CO 80301-3346
Phone (303) 475-4755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09923981COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Senior Adcocates Clinical Past Accepting new patients

Organizations & group practices 1

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": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1366807117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 GUNPARK DR STE 370-206",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013346",
            "telephone_number": "303-475-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 GUNPARK DR STE 370-206",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013346",
            "telephone_number": "303-475-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORDY",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09923981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.