Crystal Gerlock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09926109 Issued in CO

Practice address

1207 Pueblo Boulevard Way
Pueblo, CO 81005-2175

Phone

(719) 542-0032

Fax

(719) 542-1413

NPI assigned

Aug 13, 2019

Last updated

Aug 13, 2019By the provider in NPPES

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

Electronic endpoints 1

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, 2009

Medicare assignment

May accept Medicare assignment

Group practices

A New Leaf Therapy PLLCGroup PAC ID 8628346582, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• A New Leaf Therapy, PLLC

  • Community/Behavioral Health Agency
  • Pueblo, CO
  • NPI 1194111500
  Medicare reassignment Care Compare group NPD
• A New Leaf Therapy, LLC

  • Multi-Specialty Clinic/Center
  • Pueblo, CO
  • NPI 1598469132
  NPD (past)
• A New Leaf Therapy, LLC

  • Multi-Specialty Clinic/Center
  • Pueblo, CO
  • NPI 1811691447
  NPD (past)

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1558917898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 PUEBLO BOULEVARD WAY",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052175",
            "telephone_number": "719-542-0032",
            "fax_number": "719-542-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 PUEBLO BOULEVARD WAY",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810052175",
            "telephone_number": "719-542-0032",
            "fax_number": "719-542-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERLOCK",
        "first_name": "CRYSTAL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.gerlock@sangre.org",
            "affiliation": "N",
            "address_1": "1207 Pueblo Boulevard Way",
            "city": "Pueblo",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810052175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Justin P Genova
• Marjorie Genova, M.A., L.P.C.
• Audrey L Gentile, NP
• George Birks MD PLLC
• James F Georgis, O.D.
• Geropsych, PC
• Kristen Gettler
• Tiffany Getz, LICENSED PRACTICAL N
• Christina Gevedon
• Angela Giampaolo, M.D.

• Clinical Social Worker in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.