Individual provider Active NPI

Criston A Menz, LCSW

  • Clinical Social Worker
  • Rocky Ford, CO
National Provider Identifier
1609484062
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09928454 Issued in CO
Practice address
408 N Main St Ste F
Rocky Ford, CO 81067-1256
Phone
(719) 423-8834
Fax
(719) 316-2753
NPI assigned
Jul 21, 2020
Last updated
Aug 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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 0009923059 CO
Clinical Social Worker 1041C0700X CSW.09928454 CO Primary

Addresses

Primary practice location

408 N Main St Ste F
Rocky Ford, CO 81067-1256

Mailing address

1100 Hopkins Ave
Rocky Ford, CO 81067-2421
Phone (719) 696-0910

Other identifiers 1

IdentifierTypeStateIssuer
14671305OtherCAQH

Other names 1

  • Cris Menz Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220822001605 CO Practitioner - Clinical Social Worker 9032592233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

408 N Main St
Suite F
Rocky Ford, CO 81067-1256
Phone (719) 423-8834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0009923059COMDClinical Social Worker
CSW.09928454COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lotusom, LLC Clinical CurrentSince Aug 8, 2022 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Nov 2, 2022 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

408 N Main St
Ste F
Rocky Ford, CO 81067
Phone (719) 423-8834

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1609484062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HOPKINS AVE",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810672421",
            "telephone_number": "719-696-0910",
            "fax_number": "719-316-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N MAIN ST STE F",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810671256",
            "telephone_number": "719-423-8834",
            "fax_number": "719-316-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENZ",
        "first_name": "CRISTON",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "0009923059",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14671305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRIS",
            "last_name": "MENZ",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rocky Ford, CO

Sources for this page

Verify at the official NPI Registry.