Individual provider Active NPI

Levi Lagrow

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1457770034
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09930241 Issued in CO
Practice address
1304 Chinook LN
Pueblo, CO 81001-1851
Phone
(719) 545-2746
NPI assigned
Apr 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X CSW.09930241 CO Primary

Addresses

Primary practice location

1304 Chinook LN
Pueblo, CO 81001-1851

Mailing address

41 Montebello Rd Ste 204
Pueblo, CO 81001-1379
Phone (719) 545-2746

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
I20240528002119 CO Practitioner - Clinical Social Worker 8921440561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health SolutionsGroup PAC ID 0143110668, 39 clinicians

Practice addresses (Care Compare)

1304 Chinook LN
Pueblo, CO 81001-1851
Phone (719) 545-2746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09930241COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Health Solutions CurrentSince Apr 20, 2024 Accepting new patients
Health Solutions CurrentSince Apr 20, 2024 Accepting new patients
Health Solutions Current Accepting new patients
Health Solutions Past Accepting new patients

Locations

1302 Chinook Ln
Pueblo, CO 81001

41 Montebello Rd
Ste 204
Pueblo, CO 81001
Phone (719) 423-1341

2003 E 4th St
Pueblo, CO 81001
Phone (719) 544-6373

41 Montebello Rd
Lowr LL1
Pueblo, CO 81001

41 Montebello Rd
Ste 202
Pueblo, CO 81001
Phone (719) 423-1341

1304 Chinook Ln
Pueblo, CO 81001
Phone (719) 562-3222

1012 W Abriendo Ave
Pueblo, CO 81004
Phone (719) 583-2207

1310 Chinook Ln
Pueblo, CO 81001

1026 W Abriendo Ave
Pueblo, CO 81004
Phone (719) 423-1193

41 Montebello Rd
Ste 116
Pueblo, CO 81001
Phone (719) 423-1500

41 Montebello Rd
Ste 100
Pueblo, CO 81001

910 E Main St
Trinidad, CO 81082
Phone (719) 631-3370

417 S Indiana Ave
Trinidad, CO 81082
Phone (719) 846-4416

926 Russell Ave
Walsenburg, CO 81089
Phone (719) 738-2386

Organizations & group practices 4

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1457770034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD STE 204",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011379",
            "telephone_number": "719-545-2746",
            "fax_number": "719-545-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 CHINOOK LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011851",
            "telephone_number": "719-545-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGROW",
        "first_name": "LEVI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09930241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.