Individual provider Active NPI

Mary Elizabeth Fortson, PHD, LCSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1386916112
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09925967 Issued in CO
Practice address
720 S Colorado Blvd PH N
Denver, CO 80246-1962
Phone
(970) 286-7360
NPI assigned
Feb 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW76147 CA
Clinical Social Worker 1041C0700X CSW004998 GA
Clinical Social Worker 1041C0700X CSW.09925967 CO Primary

Addresses

Primary practice location

720 S Colorado Blvd PH N
Denver, CO 80246-1962

Mailing address

4285 Satinwood Dr
Johnstown, CO 80534-9083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CO, CA, MT4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20250317000265 GA Practitioner - Clinical Social Worker 7416479704 Reassigns benefits to 1 organization
I20250319002805 CO Practitioner - Clinical Social Worker 7416479704 Reassigns benefits to 1 organization
I20260106003524 CA Practitioner - Clinical Social Worker 7416479704 Reassigns benefits to 1 organization
I20260128003572 MT Practitioner - Clinical Social Worker 7416479704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCSW76147CAMDClinical Social Worker
CSW.09925967COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Nov 26, 2025 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Feb 14, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

5 W Mendenhall St
Ste 202
Bozeman, MT 59715
Phone (406) 219-7233

Organizations & group practices 2

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": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1386916112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4285 SATINWOOD DR",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805349083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S COLORADO BLVD PH N",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461962",
            "telephone_number": "970-286-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTSON",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2024-10-02",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW76147",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004998",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.