Individual provider Active NPI

Elizabeth Marie Reynolds, LMSW, LCSW

  • Clinical Social Worker
  • Thornton, CO
National Provider Identifier
1619496551
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09926430 Issued in CO
Practice address
8931 Huron St
Thornton, CO 80260-6806
Phone
(303) 853-3500
NPI assigned
Sep 12, 2017
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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 6801101797 MI
Clinical Social Worker 1041C0700X CSW.09926430 CO Primary

Addresses

Primary practice location

8931 Huron St
Thornton, CO 80260-6806

Mailing address

8931 Huron St
Thornton, CO 80260-6806

Other practice location 1

829 W Main St Ste C3
Gaylord, MI 49735-1998
Phone (989) 732-6761 ext. 2413

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
I20200930002587 CO Practitioner - Clinical Social Worker 4880013432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 N Harrison Ave
Unit a
Lafayette, CO 80026-2310
Phone (303) 578-2556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09926430COMDClinical Social Worker
6801101797MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Reach Center, Inc CurrentSince Jun 23, 2020 Accepting new patients
Realsight Counseling, PLLC Clinical CurrentSince Nov 4, 2024 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Sep 14, 2023 Accepting new patients
Community Reach Center, Inc CurrentSince Jun 23, 2020 Accepting new patients

Locations

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

104 N Harrison Ave
Unit A
Lafayette, CO 80026
Phone (303) 578-2556

8931 Huron St
Thornton, CO 80260
Phone (303) 853-3433

8989 Huron St
Thornton, CO 80260
Phone (303) 853-3511

Organizations & group practices 4

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": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1619496551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8931 HURON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802606806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 HURON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802606806",
            "telephone_number": "303-853-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 W Main St Ste C3",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351998",
            "country_code": "US",
            "telephone_number": "989-732-6761 x2413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801101797",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.