Individual provider Active NPI

Samantha Wogan, LCSW

  • Clinical Social Worker
  • Littleton, CO
National Provider Identifier
1447760293
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09928148 Issued in CO
Practice address
9632 W Chatfield Ave Unit D
Littleton, CO 80128-5060
Phone
(219) 239-6557
NPI assigned
Oct 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 09928148 CO Primary

Addresses

Primary practice location

9632 W Chatfield Ave Unit D
Littleton, CO 80128-5060

Mailing address

9632 W Chatfield Ave Unit D
Littleton, CO 80128-5060
Phone (219) 239-6557

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
I20230630000408 CO Practitioner - Clinical Social Worker 6608235171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
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
09928148COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jun 16, 2023 Accepting new patients
Eclipse Therapy LLC Past Accepting new patients
Eclipse Therapy LLC Past Accepting new patients

Locations

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

Organizations & group practices 3

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": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1447760293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9632 W CHATFIELD AVE UNIT D",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801285060",
            "telephone_number": "219-239-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9632 W CHATFIELD AVE UNIT D",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801285060",
            "telephone_number": "219-239-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOGAN",
        "first_name": "SAMANTHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09928148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.