Active NPI
Mary Elizabeth Fortson, PHD, LCSW
- Clinical Social Worker
- Denver, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW.09925967
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 4
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW76147 | CA | MD | Clinical Social Worker |
| CSW.09925967 | CO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Clinical | Current | Accepting new patients |
| Grow Healthcare Group PA | Clinical | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.