Individual provider Active NPI

Elaine Louise Blinn

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1639272966
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW989348 Issued in CO
Practice address
902 Lakeview Ave
Pueblo, CO 81004-3597
Phone
(719) 560-5855
Fax
(719) 560-5097
NPI assigned
Sep 5, 2006
Last updated
Feb 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW989348 CO Primary

Addresses

Primary practice location

902 Lakeview Ave
Pueblo, CO 81004-3597

Mailing address

Dept 1188
Denver, CO 80291-1188
Phone (303) 486-5504

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
I20120427000672 CO Practitioner - Clinical Social Worker 8022270594 Practice locations: Centennial, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW989348COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Past Accepting new patients

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1639272966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 1188",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911188",
            "telephone_number": "303-486-5504",
            "fax_number": "303-486-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 LAKEVIEW AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043597",
            "telephone_number": "719-560-5855",
            "fax_number": "719-560-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLINN",
        "first_name": "ELAINE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW989348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.