Individual provider Active NPI

George Garry, LCSW

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1417400474
Registry record updated Sep 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117 Issued in CO
Practice address
5884 N Orchard Creek Cir
Boulder, CO 80301-5834
Phone
(303) 444-5280
NPI assigned
Jul 26, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2018

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 117 CO Primary

Addresses

Primary practice location

5884 N Orchard Creek Cir
Boulder, CO 80301-5834

Mailing address

5884 N Orchard Creek Cir
Boulder, CO 80301-5834
Phone (303) 444-5280

Other practice location 1

1155 Alpine Ave Fl 2
Boulder, CO 80304-3495
Phone (303) 415-4297

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
I20180928000743 CO Practitioner - Clinical Social Worker 3072864115 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Aug 13, 2018 Accepting new patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince Aug 13, 2018 Accepting new patients
Boulder Community Health Past Accepting new patients
George a Garry Past Accepting new patients

Locations

4801 Riverbend Rd
Ste 300
Boulder, CO 80301
Phone (303) 415-8621

4801 Riverbend Rd
Ste 120A
Boulder, CO 80301
Phone (303) 415-4299

1155 Alpine Ave
Fl 2
Boulder, CO 80304
Phone (303) 415-4297

Organizations & group practices 5

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": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1417400474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5884 N ORCHARD CREEK CIR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803015834",
            "telephone_number": "303-444-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5884 N ORCHARD CREEK CIR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803015834",
            "telephone_number": "303-444-5280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 Alpine Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803043495",
            "country_code": "US",
            "telephone_number": "303-415-4297",
            "fax_number": "303-441-2202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARRY",
        "first_name": "GEORGE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.