Individual provider Active NPI

Pamela Joy De Mayo, LCSW

  • Clinical Social Worker
  • Lafayette, CO
National Provider Identifier
1396876538
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
991303 Issued in CO
Practice address
400 E Simpson St
Suite 202
Lafayette, CO 80026-2394
Phone
(720) 562-0525
Fax
(303) 661-0818
NPI assigned
Mar 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 991303 CO Primary

Addresses

Primary practice location

400 E Simpson St
Suite 202
Lafayette, CO 80026-2394

Mailing address

400 E Simpson St
Suite 202
Lafayette, CO 80026-2394
Phone (720) 562-0525

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
I20170606000554 CO Practitioner - Clinical Social Worker 8426325838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
991303COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396876538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SIMPSON ST",
            "address_2": "SUITE 202",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262394",
            "telephone_number": "720-562-0525",
            "fax_number": "303-661-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E SIMPSON ST",
            "address_2": "SUITE 202",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262394",
            "telephone_number": "720-562-0525",
            "fax_number": "303-661-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MAYO",
        "first_name": "PAMELA",
        "middle_name": "JOY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "991303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.