Individual provider Active NPI

Brenda Dalen

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1598125387
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09927122 Issued in CO
Practice address
2790 N Academy Blvd Ste 337
Colorado Springs, CO 80917-5328
Phone
(719) 445-6104
Fax
(719) 425-3374
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2015-000239 NJ
Social Worker 104100000X 44SL06018600 NJ
Clinical Social Worker 1041C0700X CSW.09927122 CO Primary

Addresses

Primary practice location

2790 N Academy Blvd Ste 337
Colorado Springs, CO 80917-5328

Mailing address

2790 N Academy Blvd Ste 337
Colorado Springs, CO 80917-5328
Phone (719) 445-6104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
60.28 of 100Reported as group
Quality
23.87
Improvement activities
40
Cost
82.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2015-000239NJMDAddiction (Substance Use Disorder) Counselor
44SL06018600NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Resilient Trails Therapeutic Services PLLC Clinical CurrentSince Jun 23, 2024 Accepting new patients

Locations

2790 N Academy Blvd
Ste 337
Colorado Springs, CO 80917
Phone (719) 445-6104

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": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1598125387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 N ACADEMY BLVD STE 337",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175328",
            "telephone_number": "719-445-6104",
            "fax_number": "719-425-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 N ACADEMY BLVD STE 337",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175328",
            "telephone_number": "719-445-6104",
            "fax_number": "719-425-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEN",
        "first_name": "BRENDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "2015-000239",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06018600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09927122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.