Active NPI
Jordan Brooks, LCSW
- Clinical Social Worker
- Fort Collins, CO
National Provider Identifier
1508474834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 09928217
- Practice address
- 2850 McClelland Dr
Fort Collins, CO 80525-2586 - Phone
- (970) 900-6179
- NPI assigned
- Jul 22, 2020
- Last updated
- Jul 11, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 09928217 | CO | Primary |
Addresses
Primary practice location
2850 McClelland Dr
Fort Collins, CO 80525-2586
Mailing address
2850 McClelland Dr Ste 3600
Fort Collins, CO 80525-2587
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09928217 | CO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rainbow Circles, LLC | Clinical | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1508474834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2850 MCCLELLAND DR STE 3600",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805252587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2850 MCCLELLAND DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805252586",
"telephone_number": "970-900-6179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "JORDAN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-22",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "09928217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.