Gladys Patricia Tellez-Villa, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LSW.0009924086 Issued in CO

Practice address

439 Edwards Access Rd # B204
Edwards, CO 81632-5634

Phone

(970) 422-3029

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Valley Mental HealthGroup PAC ID 6204297450, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eagle Valley Mental Health

  • Community/Behavioral Health Agency
  • Edwards, CO
  • NPI 1972267292
  Medicare reassignment Care Compare group NPD
• Eagle Valley Mental Health

  • Community/Behavioral Health Agency
  • Vail, CO
  • NPI 1063210946
  NPD

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1538853437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 EDWARDS ACCESS RD # B204",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816325634",
            "telephone_number": "970-422-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 EDWARDS ACCESS RD # B204",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816325634",
            "telephone_number": "970-422-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLEZ-VILLA",
        "first_name": "GLADYS",
        "middle_name": "PATRICIA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "LSW.0009924086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Steele, PSYD
• Caleb Jayce Steen, RN BSN, MSN, PMHNP
• Gretchen Stich
• Dustin Thomas Straight, MS, LAC
• Cody Teleki
• Ellen Durrance Terry, OTR/L
• The Deeper Connections, LLC/Dba Stacey Horn
• The Everyday OT, LLC
• The Vail Mind Center
• Christopher K Thiagarajah, MD

• Social Worker in Edwards, CO
• Providers in Edwards, CO by specialty
• Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.