Individual provider Active NPI

Deborah Kolker Mastin, MSW, LCSW

  • Clinical Social Worker
  • Parker, CO
National Provider Identifier
1366925349
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
991234 Issued in CO
Practice address
19753 E. Pikes Peak Ave
Parker, CO 80138
Phone
(303) 810-8290
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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 991234 CO Primary

Addresses

Primary practice location

19753 E. Pikes Peak Ave
Parker, CO 80138

Mailing address

19753 E. Pikes Peak Ave Suite 202
Parker, CO 80138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
991234COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1366925349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19753 E. PIKES PEAK AVE SUITE 202",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19753 E. PIKES PEAK AVE",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80138",
            "telephone_number": "303-810-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTIN",
        "first_name": "DEBORAH",
        "middle_name": "KOLKER",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "991234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.