NPIMap

Organization Active NPI

Blue Channel Therapy

  • Clinical Social Worker
  • Aurora, CO
National Provider Identifier
1538890892
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BLUE CHANNEL THERAPY
Practice address
14901 E Hampden Ave Ste 120
Aurora, CO 80014-5037
Phone
(720) 295-7548
NPI assigned
Jun 18, 2022
Last updated
Jun 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Authorized official

Name
Maia LongeneckerNPI 1497180129
Title
Owner
Phone
(720) 295-7548

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)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

14901 E Hampden Ave Ste 120
Aurora, CO 80014-5037

Mailing address

5460 Ward Rd Ste 150
Arvada, CO 80002-1828
Phone (720) 295-7548

Other identifiers 1

IdentifierTypeStateIssuer
9000190521MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Blue Channel Therapy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14901 E Hampden Ave
Ste 120
Aurora, CO 80014
Phone (720) 295-7548

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1655510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1538890892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 WARD RD STE 150",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800021828",
            "telephone_number": "720-295-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 E HAMPDEN AVE STE 120",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800145037",
            "telephone_number": "720-295-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CHANNEL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-18",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "LONGENECKER",
        "authorized_official_first_name": "MAIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-295-7548"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000190521",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.

Verify at the official NPI Registry.