Individual provider Active NPI

Anisha Perez, LCSW

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1679350540
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09928515 Issued in CO
Practice address
416 Colorado Ave
Pueblo, CO 81004-2011
Phone
(719) 320-1256
NPI assigned
Sep 13, 2023
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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 CSW.09928515 CO Primary

Addresses

Primary practice location

416 Colorado Ave
Pueblo, CO 81004-2011

Mailing address

27 Thames Dr
Pueblo, CO 81005-3512
Phone (719) 320-1256

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
I20240419001654 CO Practitioner - Clinical Social Worker 2264871482 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

416 Colorado Ave
Pueblo, CO 81004-2011
Phone (719) 320-1256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09928515COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Tree Counseling Clinical CurrentSince Mar 4, 2024 Accepting new patients
Achieving Life's Potential Alp Counseling LLC Clinical CurrentSince Feb 1, 2025 Accepting new patients
Renew You Counseling and Therapy Center PC Clinical CurrentSince Aug 1, 2024 Accepting new patients
Tafoya Family Practice LLC Past Accepting new patients

Locations

416 Colorado Ave
Pueblo, CO 81004
Phone (719) 320-1256

503 N Main St
Ste 654
Pueblo, CO 81003
Phone (719) 766-9362

Organizations & group practices 4

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": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1679350540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 THAMES DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053512",
            "telephone_number": "719-320-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042011",
            "telephone_number": "719-320-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ANISHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.