Individual provider Active NPI

Brooke Tuttle Jostad, MSW, LCSW

  • Clinical Social Worker
  • Fort Collins, CO
National Provider Identifier
1578939864
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09925268 Issued in CO
Practice address
2550 Stover St BLDG C
Fort Collins, CO 80525-4641
Phone
(970) 942-3031
Fax
(307) 426-4799
NPI assigned
Aug 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-1359 WY
Clinical Social Worker 1041C0700X CSW.09925268 CO Primary

Addresses

Primary practice location

2550 Stover St BLDG C
Fort Collins, CO 80525-4641

Mailing address

4025 Rawlins St
Cheyenne, WY 82001-1900
Phone (307) 426-4797

Other practice location 1

4025 Rawlins St
Cheyenne, WY 82001-1900
Phone (307) 426-4797

Other identifiers 1

IdentifierTypeStateIssuer
9000175168MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191106001028 CO Practitioner - Clinical Social Worker 2264764521 Reassigns benefits to 1 organization
I20220429000512 WY Practitioner - Clinical Social Worker 2264764521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Counseling and ConsultingGroup PAC ID 8921311911, 14 clinicians

Practice addresses (Care Compare)

1413 W 29TH St
Loveland, CO 80538-2403
Phone (970) 942-3037

2550 Stover St
BLDG C
Fort Collins, CO 80525-4641
Phone (970) 942-3031

4025 Rawlins St
Cheyenne, WY 82001-1900
Phone (307) 426-4797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Counseling & Consulting CurrentSince Sep 1, 2019 Accepting new patients
Midway Youth Services, Inc Past Accepting new patients

Locations

2550 Stover St
Bldg C
Fort Collins, CO 80525
Phone (307) 426-4798

4025 Automation Way
Unit A2
Fort Collins, CO 80525
Phone 3074264798202

4025 Rawlins St
Cheyenne, WY 82001
Phone (307) 426-4797

Organizations & group practices 2

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": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1578939864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 RAWLINS ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011900",
            "telephone_number": "307-426-4797",
            "fax_number": "307-426-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 STOVER ST BLDG C",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254641",
            "telephone_number": "970-942-3031",
            "fax_number": "307-426-4799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4025 Rawlins St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820011900",
            "country_code": "US",
            "telephone_number": "307-426-4797",
            "fax_number": "307-426-4799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSTAD",
        "first_name": "BROOKE",
        "middle_name": "TUTTLE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-1359",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000175168",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.