Individual provider Active NPI

Jaclyn Delong, LCSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1467908889
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09925552 Issued in CO
Practice address
2560 W 29TH Ave
Denver, CO 80211-3712
Phone
(303) 477-8280
NPI assigned
Aug 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACB.0007954 CO
Mental Health Counselor 101YM0800X NLC.0105727 CO
Clinical Social Worker 1041C0700X 88755 CA
Clinical Social Worker 1041C0700X CSW.09925552 CO Primary

Addresses

Primary practice location

2560 W 29TH Ave
Denver, CO 80211-3712

Mailing address

12510 Roosevelt LN Apt E1
Englewood, CO 80112-7028
Phone (720) 296-4165

Other practice location 1

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (310) 627-5850

Other identifiers 1

IdentifierTypeStateIssuer
84902248MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACB.0007954COMDAddiction (Substance Use Disorder) Counselor
NLC.0105727COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Roads Foundation, Inc. CurrentSince May 1, 2019 Accepting new patients

Locations

121 S Long Beach Blvd
Compton, CA 90221
Phone (310) 627-5850

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1467908889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12510 ROOSEVELT LN APT E1",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801127028",
            "telephone_number": "720-296-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 W 29TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802113712",
            "telephone_number": "303-477-8280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 S Long Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Compton",
            "state": "CA",
            "postal_code": "902213423",
            "country_code": "US",
            "telephone_number": "310-627-5850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELONG",
        "first_name": "JACLYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACB.0007954",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "NLC.0105727",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "88755",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84902248",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.