Tanya Laray Balduff, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09927730 Issued in CO

Practice address

2790 N Academy Blvd Ste 337
Colorado Springs, CO 80917-5328

Phone

(910) 286-5447

NPI assigned

Sep 25, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tanya Hoaglin Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Resilient Trails Therapeutic Services PLLC

  • Clinical Social Worker
  • Colorado Springs, CO
  • NPI 1124798608
  Medicare reassignment Authorized official
• Deaf Mountain, PLLC

  • Mental Health Counselor
  • Colorado Springs, CO
  • NPI 1407539885
  NPD

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1669981478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 N ACADEMY BLVD STE 337",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175328",
            "telephone_number": "910-286-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 N ACADEMY BLVD STE 337",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175328",
            "telephone_number": "910-286-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDUFF",
        "first_name": "TANYA",
        "middle_name": "LARAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "LSW.0009922970",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09927730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "HOAGLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Maria Chavez Balch
• Haley Jean Balcom, OTR/L
• Cassandra Balcome
• Caryn D Baldauf, MD
• Brenda Sue Baldry, M.ED., LPC
• Ashley Baldwin, LPC, CAC II
• Chante Baldwin
• Gregory Maynard Baldwin, LCSW
• Melissa Baldwin
• Rebecca Anne Baldwin, PH.D.

• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.