Individual provider Active NPI

Devon Emmanuel

  • Addiction (Substance Use Disorder) Counselor
  • Denver, CO
National Provider Identifier
1396407862
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ACD.0002209 Issued in CO
Practice address
1724 Vine St
Denver, CO 80206-1120
Phone
(720) 336-8881
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWC0000000181 CO
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0002209 CO Primary

Addresses

Primary practice location

1724 Vine St
Denver, CO 80206-1120

Mailing address

821 E Railroad Ave
Fort Morgan, CO 80701-3365

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
ACD.0002209COMDAddiction (Substance Use Disorder) Counselor
SWC0000000181COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1396407862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E RAILROAD AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 VINE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802061120",
            "telephone_number": "720-336-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMANUEL",
        "first_name": "DEVON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "SWC0000000181",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0002209",
            "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 Apr 10, 2023; 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.