Organization Active NPI

Reynel Mirabal

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1629854930
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
REYNEL MIRABAL
Practice address
5525 Erindale Dr Ste 201
Colorado Springs, CO 80918-6962
Phone
(305) 773-7927
NPI assigned
Sep 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Authorized official

Name
Reynel Mirabal, LCSWNPI 1700384112
Title
Therapist
Phone
(305) 773-7927

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

5525 Erindale Dr Ste 201
Colorado Springs, CO 80918-6962

Mailing address

3670 Queen Anne Way
Colorado Springs, CO 80917-5491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250306001886 CO Part B Supplier - Clinic/Group Practice 1850812843 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

5525 Erindale Dr
Ste 201B
Colorado Spgs, CO 80918

5525 Erindale Dr
Ste 201
Colorado Springs, CO 80918
Phone (305) 773-7927

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1629854930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 QUEEN ANNE WAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ERINDALE DR STE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809186962",
            "telephone_number": "305-773-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNEL MIRABAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-01",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "MIRABAL",
        "authorized_official_first_name": "REYNEL",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "305-773-7927",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.