Individual provider Active NPI

Elisa Alvim-Told, LCSW

  • Clinical Social Worker
  • Craig, CO
National Provider Identifier
1639587397
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09923637 Issued in CO
Practice address
580 Pershing St Ste 1
Craig, CO 81625-3053
Phone
(917) 730-7789
Fax
(970) 367-1499
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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 9923637 CO
Clinical Social Worker 1041C0700X 09923637 CO Primary

Addresses

Primary practice location

580 Pershing St Ste 1
Craig, CO 81625-3053

Mailing address

2340 W 1620 North Cir
St George, UT 84770-5313
Phone (917) 730-7789

Other practice location 1

2340 W 1620 North Cir
St George, UT 84770-5313
Phone (917) 730-7789

Other identifiers 2

IdentifierTypeStateIssuer
1127OtherCONONE
52720586MedicaidCO

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
I20150521000299 CO Practitioner - Clinical Social Worker 7315267051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Columbia University College of Physicians and Surgeons, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2340 W 1620 N Cir
Saint George, UT 84770-5313

5783 Haywagon LN
Castle Rock, CO 80108-8584

580 Pershing St
Suite 1
Craig, CO 81625-3053
Phone (917) 730-7789

9362 Amison Circle
Unit 102
Parker, CO 80134-7698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09923637COMDClinical Social Worker
9923637COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ivy Psychotherapies LLC Clinical CurrentSince Sep 11, 2024 Accepting new patients

Locations

580 Pershing St
Ste 1
Craig, CO 81625
Phone (917) 730-7789

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1639587397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 W 1620 NORTH CIR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705313",
            "telephone_number": "917-730-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 PERSHING ST STE 1",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816253053",
            "telephone_number": "917-730-7789",
            "fax_number": "970-367-1499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2340 W 1620 North Cir",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847705313",
            "country_code": "US",
            "telephone_number": "917-730-7789",
            "fax_number": "970-367-1499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALVIM-TOLD",
        "first_name": "ELISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "9923637",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09923637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "1127",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52720586",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Craig, CO

Sources for this page

Verify at the official NPI Registry.