Individual provider Active NPI

Michael R Dell, LCSW

  • Clinical Social Worker
  • Englewood, CO
National Provider Identifier
1629174438
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
992544 Issued in CO
Practice address
3240 S Corona St
Englewood, CO 80113-2816
Phone
(303) 622-5698
NPI assigned
Sep 16, 2006
Last updated
Apr 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 077486-1 NY
Clinical Social Worker 1041C0700X 44SC05079100 NJ
Clinical Social Worker 1041C0700X CW015444 PA
Clinical Social Worker 1041C0700X 992544 CO Primary

Addresses

Primary practice location

3240 S Corona St
Englewood, CO 80113-2816

Mailing address

PO Box 100856
Denver, CO 80250-0856
Phone (303) 622-5698

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
I20141015001501 CO Practitioner - Clinical Social Worker 0345288148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3240 S Corona St
Englewood, CO 80113-2816
Phone (303) 622-5698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
992544COMDClinical Social Worker
077486-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Live Your Wellness LLC Clinical CurrentSince Oct 15, 2015 Accepting new patients

Locations

2401 S Downing St
Denver, CO 80210
Phone (303) 733-2727

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1629174438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100856",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802500856",
            "telephone_number": "303-622-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 S CORONA ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132816",
            "telephone_number": "303-622-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELL",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077486-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05079100",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015444",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "992544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.