Individual provider Active NPI

Jessica M Woods, LCSW

  • Clinical Social Worker
  • Broomfield, CO
National Provider Identifier
1619493244
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.009925060 Issued in CO
Practice address
11820 Destination Dr
Broomfield, CO 80021-2518
Phone
(303) 460-6000
NPI assigned
Aug 15, 2017
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 9920499 CO
Clinical Social Worker 1041C0700X CSW.009925060 CO Primary

Addresses

Primary practice location

11820 Destination Dr
Broomfield, CO 80021-2518

Mailing address

11820 Destination Dr
Broomfield, CO 80021-2518

Other practice location 1

10241 Park Meadows Dr
Lone Tree, CO 80124-1114
Phone (303) 649-5464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, AZ2 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
I20230711003818 CO Practitioner - Clinical Social Worker 0941669717 Reassigns benefits to 1 organization
I20250826001499 AZ Practitioner - Clinical Social Worker 0941669717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

20 E Thomas Rd
Suite 2200
Phoenix, AZ 85012-3133
Phone (866) 630-0966

720 S Colorado Blvd
PH North
Denver, CO 80246-1904
Phone (844) 843-7279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9920499COMDSocial Worker
CSW.009925060COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jul 7, 2025 Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

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

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, 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": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1619493244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11820 DESTINATION DR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 DESTINATION DR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212518",
            "telephone_number": "303-460-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10241 Park Meadows Dr",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801241114",
            "country_code": "US",
            "telephone_number": "303-649-5464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODS",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "9920499",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.009925060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.