Active NPI
Joni Pearl, LCSW
- Clinical Social Worker
- Evergreen, CO
National Provider Identifier
1679630529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 989057
- Practice address
- 29029 Upper Bear Creek Rd
#302
Evergreen, CO 80439-7738 - Phone
- (303) 670-6501
- NPI assigned
- Jan 2, 2007
- Last updated
- Jul 8, 2007
- 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 | 989057 | CO | Primary |
Addresses
Primary practice location
29029 Upper Bear Creek Rd
#302
Evergreen, CO 80439-7738
Mailing address
29029 Upper Bear Creek Rd
#302
Evergreen, CO 80439-7738
Phone (303) 670-6501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Sep 8, 2015 through Sep 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 989057 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679630529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29029 UPPER BEAR CREEK RD",
"address_2": "#302",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804397738",
"telephone_number": "303-670-6501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29029 UPPER BEAR CREEK RD",
"address_2": "#302",
"city": "EVERGREEN",
"state": "CO",
"postal_code": "804397738",
"telephone_number": "303-670-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARL",
"first_name": "JONI",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "989057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.