Kristie Phillips

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW1347 Issued in CO

Practice address

28 Radcliff LN
Pueblo, CO 81005-1912

Phone

(719) 214-0293

NPI assigned

Mar 9, 2007

Last updated

Apr 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1629100318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 RADCLIFF LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051912",
            "telephone_number": "719-214-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 RADCLIFF LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051912",
            "telephone_number": "719-214-0293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Chinook Ln",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810011851",
            "country_code": "US",
            "telephone_number": "719-545-2746",
            "fax_number": "719-584-0119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KRISTIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW1347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PHHC Acquisition Corp. (CenterWell Home Health)
• Philip C. Marin, MD Prof LLC
• Brandi Philipps
• Cody Phillips
• Jennifer Phillips
• Marisa K Phillips, NP
• Misty Marie Phillips, RN
• Greg Allen Philson, DDS
• Physical Therapy Connections, PC
• Physical, Rehabilitative and Occupational Medicine Center LLC (PRO Medicine LLC)

• Clinical Social Worker in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.