Mamie Tisue, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09924968 Issued in CO

Practice address

134 F St Ste 201
Salida, CO 81201-2160

Phone

(309) 236-3254

NPI assigned

Oct 4, 2018

Last updated

Dec 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mental Health Center of Denver

  dba WellPower

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Denver, CO
  • NPI 1396566444
  Medicare reassignment NPD
• Wild Roots Therapeutics

  • Clinical Social Worker
  • Salida, CO
  • NPI 1922853779
  NPD Authorized official
• Mental Health Center of Denver

  dba WellPower

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Denver, CO
  • NPI 1407643679
  NPD
• Mental Health Center of Denver

  dba WellPower

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Denver, CO
  • NPI 1467048744
  NPD

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1700351905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1355",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812011355",
            "telephone_number": "309-236-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 F ST STE 201",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812012160",
            "telephone_number": "309-236-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISUE",
        "first_name": "MAMIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09924968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Well Aesthetics and Wellness PLLC (The Well)
• Therapy Muse LLC
• Third Ear Counseling, LLC
• Thrive Physical Therapy, LLC
• Anthony Louis Timko, M.D.
• Eugene Tkatschenko
• Toc, Inc. (Touch of Care)
• Marion Eleanor Toll, NP
• Transitions Behavioral Health
• Jonathan Trenary, PHARM D.

• Clinical Social Worker in Salida, CO
• Providers in Salida, 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 Dec 11, 2024; 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.