Individual provider Active NPI

Kristen Emillia Dammer

  • Clinical Social Worker
  • Lakewood, CO
National Provider Identifier
1558556472
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00001627 Issued in CO
Practice address
9808 W Cedar Ave
Lakewood, CO 80226-1023
Phone
(303) 432-5400
NPI assigned
Sep 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 00001627 CO Primary

Addresses

Primary practice location

9808 W Cedar Ave
Lakewood, CO 80226-1023

Mailing address

9808 W Cedar Ave
Lakewood, CO 80226-1023
Phone (303) 432-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20250303000428 MN Practitioner - Clinical Social Worker 0244417756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeview Behavioral Health IncGroup PAC ID 9537432307, 24 clinicians

Practice addresses (Care Compare)

516 S Pokegama Ave
Grand Rapids, MN 55744-3800
Phone (218) 327-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00001627COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Behavioral Health Inc. CurrentSince Feb 1, 2025 Accepting new patients

Locations

516 S Pokegama Ave
Grand Rapids, MN 55744
Phone (218) 327-2001

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1558556472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 W CEDAR AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802261023",
            "telephone_number": "303-432-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 W CEDAR AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802261023",
            "telephone_number": "303-432-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMMER",
        "first_name": "KRISTEN",
        "middle_name": "EMILLIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "00001627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.