Individual provider Active NPI

Selena Ann Papaconstantinou, LCSW

  • Clinical Social Worker
  • Edgewater, CO
National Provider Identifier
1720739618
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09927898 Issued in CO
Practice address
2020 Kendall St
Edgewater, CO 80214-1040
Phone
(917) 807-1048
NPI assigned
Jan 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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.09927898 CO Primary

Addresses

Primary practice location

2020 Kendall St
Edgewater, CO 80214-1040

Mailing address

2020 Kendall St
Edgewater, CO 80214-1040
Phone (917) 807-1048

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
I20241125003864 CO Practitioner - Clinical Social Worker 8820523442 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09927898COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Towards Wholeness Clinical CurrentSince Oct 15, 2024 Accepting new patients
Healing Towards Wholeness Clinical CurrentSince Oct 15, 2024 Accepting new patients

Locations

3701 W Radcliff Ave
Denver, CO 80236
Phone (303) 232-3551

609 E Speer Blvd
Ste 301
Denver, CO 80203
Phone (720) 772-9211

1 Kalisa Way
Ste 101
Paramus, NJ 07652

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1720739618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 KENDALL ST",
            "city": "EDGEWATER",
            "state": "CO",
            "postal_code": "802141040",
            "telephone_number": "917-807-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 KENDALL ST",
            "city": "EDGEWATER",
            "state": "CO",
            "postal_code": "802141040",
            "telephone_number": "917-807-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPACONSTANTINOU",
        "first_name": "SELENA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09927898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, CO

Sources for this page

Verify at the official NPI Registry.