Individual provider Active NPI

Jennifer Layne Burnett, LCSW

  • Clinical Social Worker
  • Greeley, CO
National Provider Identifier
1417973835
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09923444 Issued in CO
Practice address
3400 W 16TH St
Building 7, Suite I
Greeley, CO 80634
Phone
(970) 324-4976
NPI assigned
Jul 15, 2006
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 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 250 WY
Clinical Social Worker 1041C0700X CSW.09923444 CO Primary

Addresses

Primary practice location

3400 W 16TH St
Building 7, Suite I
Greeley, CO 80634

Mailing address

1226 43Rd Ave
Greeley, CO 80634-2433
Phone (970) 324-4976

Other practice location 1

1770 25th Ave Ste 200
Greeley, CO 80634-4949
Phone (970) 691-1880

Other practice location 2

604 E 25th St
Cheyenne, WY 82001-3133
Phone (307) 637-3953

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
I20171012002487 CO Practitioner - Clinical Social Worker 6608141999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

720 S Colorado Blvd
PH North
Denver, CO 80246-1904
Phone (844) 843-7279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
250WYMDMental Health Counselor
CSW.09923444COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Mar 18, 2021 Accepting new patients

Locations

1738 Wynkoop St
Ste 303
Denver, CO 80202
Phone (720) 730-8981

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1417973835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 43RD AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342433",
            "telephone_number": "970-324-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 16TH ST",
            "address_2": "BUILDING 7, SUITE I",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-324-4976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1770 25th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806344949",
            "country_code": "US",
            "telephone_number": "970-691-1880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "604 E 25th St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820013133",
            "country_code": "US",
            "telephone_number": "307-637-3953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "JENNIFER",
        "middle_name": "LAYNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "250",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09923444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.