Individual provider Active NPI

Jacquelyn De'Anda, LSW, SWC, MSW

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1730002940
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW.0009927115 Issued in CO
Practice address
329 Colorado Ave
Pueblo, CO 81004-2005
Phone
(719) 662-0329
NPI assigned
Aug 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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 LSW.0009927115 CO Primary

Addresses

Primary practice location

329 Colorado Ave
Pueblo, CO 81004-2005

Mailing address

329 Colorado Ave
Pueblo, CO 81004-2005
Phone (719) 662-0329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1730002940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042005",
            "telephone_number": "719-662-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042005",
            "telephone_number": "719-662-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE'ANDA",
        "first_name": "JACQUELYN",
        "name_prefix": "Mrs.",
        "credential": "LSW, SWC, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "LSW.0009927115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.