Active NPI
Mountain West Wisdom and Wellness, LLC
- Clinical Social Worker
- Lakewood, CO
National Provider Identifier
1467292003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- MOUNTAIN WEST WISDOM AND WELLNESS, LLC
- Practice address
- 7114 W Jefferson Ave Ste 207
Lakewood, CO 80235-2356 - Phone
- (720) 258-6278
- NPI assigned
- May 30, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Diane Fern, LCSW
- Title
- Owner
- Phone
- (402) 617-8683
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
7114 W Jefferson Ave Ste 207
Lakewood, CO 80235-2356
Mailing address
10233 Cavaletti Dr
Littleton, CO 80125-7940
Phone (401) 617-8683
Other names 1
- Diane Fern, LCSW
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
7114 W Jefferson Ave
Ste 207
Lakewood, CO 80235
Phone (720) 258-6278
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Lakewood, CO
- NPI 1598582322
-
- Clinical Social Worker
- Denver, CO
- NPI 1417728221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717027200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1717027200000",
"number": "1467292003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10233 CAVALETTI DR",
"city": "LITTLETON",
"state": "CO",
"postal_code": "801257940",
"telephone_number": "401-617-8683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7114 W JEFFERSON AVE STE 207",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802352356",
"telephone_number": "720-258-6278"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOUNTAIN WEST WISDOM AND WELLNESS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-05-30",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A",
"authorized_official_last_name": "FERN",
"authorized_official_first_name": "DIANE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "402-617-8683",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Diane Fern, LCSW",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.