Individual provider Active NPI

Lior Shpizer-Daube, LCSW

  • Clinical Social Worker
  • Broomfield, CO
National Provider Identifier
1376043216
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09928330 Issued in CO
Practice address
80 Garden Ctr
Broomfield, CO 80020-7087
Phone
(720) 378-6511
NPI assigned
Feb 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 100647-1 NY
Clinical Social Worker 1041C0700X CSW.09928330 CO Primary

Addresses

Primary practice location

80 Garden Ctr
Broomfield, CO 80020-7087

Mailing address

80 Garden Ctr
Broomfield, CO 80020-7087

Other practice location 1

10440 Queens Blvd
Forest Hills, NY 11375-3637
Phone (646) 250-9796

Other practice location 2

3303 W 144th Ave Unit 204
Broomfield, CO 80023-9601
Phone (720) 709-2810

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
I20230502002507 CO Practitioner - Clinical Social Worker 9537524210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100647-1NYMDSocial Worker
CSW.09928330COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Krueger Emh Inc. CurrentSince Mar 1, 2023 Accepting new patients
Lior Shpizer-Daube Clinical Current Accepting new patients
Lior Shpizer-Daube Clinical Current Accepting new patients

Locations

3303 W 144th Ave
Unit 204
Broomfield, CO 80023
Phone (720) 709-2810

80 Garden Ctr
Broomfield, CO 80020
Phone (303) 960-4822

80 Garden Ctr
Ste 154
Broomfield, CO 80020
Phone (303) 578-4446

Organizations & group practices 3

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": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1376043216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 GARDEN CTR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GARDEN CTR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207087",
            "telephone_number": "720-378-6511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10440 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113753637",
            "country_code": "US",
            "telephone_number": "646-250-9796",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3303 W 144th Ave Unit 204",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800239601",
            "country_code": "US",
            "telephone_number": "720-709-2810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHPIZER-DAUBE",
        "first_name": "LIOR",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "100647-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.