Active NPI
Jennifer Maccorquodale
- Clinical Social Worker
- Ft Carson, CO
National Provider Identifier
1659601714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 501
- Practice address
- 1626 Oconnell Blvd BLDG 1525
Ft Carson, CO 80913-4060 - Phone
- (719) 524-4671
- NPI assigned
- Jan 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 501 | CO | Primary |
Addresses
Primary practice location
1626 Oconnell Blvd BLDG 1525
Ft Carson, CO 80913-4060
Mailing address
1626 Oconnell Blvd
BLDG 813
Ft Carson, CO 80913-4060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 501 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1659601714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1626 OCONNELL BLVD",
"address_2": "BLDG 813",
"city": "FT CARSON",
"state": "CO",
"postal_code": "809134060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1626 OCONNELL BLVD BLDG 1525",
"city": "FT CARSON",
"state": "CO",
"postal_code": "809134060",
"telephone_number": "719-524-4671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACCORQUODALE",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-12",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Carson, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.