Prudencio a Cosyleon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

991432 Issued in CO

Legal business name

PRUDENCIO A COSYLEON

Practice address

417 W 13TH St
Pueblo, CO 81003-2703

Phone

(719) 214-0626

Fax

(719) 544-2033

NPI assigned

Aug 24, 2013

Last updated

Aug 24, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prudencio A Cosyleon, LCSWNPI 1083775498

Title

Provider

Phone

(719) 214-0626

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prudencio Cosyleon, LCSW

  • Clinical Social Worker
  • Pueblo, CO
  • NPI 1083775498
  NPD (past) Authorized official

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

{
    "created_epoch": "1377302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377302400000",
    "number": "1730513912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982 COTTON CIR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810069559",
            "telephone_number": "719-214-0626",
            "fax_number": "719-544-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032703",
            "telephone_number": "719-214-0626",
            "fax_number": "719-544-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENCIO A COSYLEON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-24",
        "last_updated": "2013-08-24",
        "status": "A",
        "authorized_official_last_name": "COSYLEON",
        "authorized_official_first_name": "PRUDENCIO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "719-214-0626",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "991432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Pueblo, CO
• Providers in Pueblo, 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 Aug 24, 2013; 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.