Kristen Kelly Greenwald, MSW, LSW
Individual provider Active NPI Social Worker · Dillon, CO
NPI 1487010682 · NPPES record last updated Aug 6, 2024
Key facts
- NPI
- 1487010682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LSW.0009922051 (CO)
- Practice address
- 330 Fiedler Ave
Dillon, CO 80435-6930 - Phone
- (970) 668-3478
- Fax
- (970) 668-0632
- NPI assigned
- Jan 5, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
PO Box
Suite 3272
Dillon, CO 80435-3272
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200429000051 | CO | Practitioner - Clinical Social Worker | 2062842313 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW.0009922051 | CO | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wild Nature Wellness LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Social Worker | 104100000X | LSW.0009922051 | CO | Yes |
Addresses
Primary practice location
330 Fiedler Ave
Dillon, CO 80435-6930
Mailing address
PO Box 272
Silverthorne, CO 80498-0272
Other providers in Dillon, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.