Individual provider Active NPI

Angelica Vazquez

  • Clinical Social Worker
  • Alamosa, CO
National Provider Identifier
1730565417
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09925744 Issued in CO
Practice address
8745 County Road 9 S
Alamosa, CO 81101-9610
Phone
(719) 587-5603
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X CSW.09925744 CO Primary

Addresses

Primary practice location

8745 County Road 9 S
Alamosa, CO 81101-9610

Mailing address

8745 County Road 9 S
Alamosa, CO 81101-9610

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
I20190515003027 CO Practitioner - Clinical Social Worker 4789927641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Luis Valley Community Mental Health Center, Inc.Group PAC ID 0345267779, 34 clinicians

Practice addresses (Care Compare)

8745 County Rd 9
Alamosa, CO 81101-9610
Phone (719) 589-3671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Valley Community Mental Health Center, Inc. CurrentSince Apr 23, 2019 Accepting new patients
Healing Oasis Counseling Clinical Current Accepting new patients
San Luis Valley Community Mental Health Center, Inc. Current Accepting new patients
San Luis Valley Community Mental Health Center, Inc. CurrentSince Apr 23, 2019 Accepting new patients
San Luis Valley Community Mental Health Center, Inc. Past Accepting new patients
San Luis Valley Community Mental Health Center, Inc. Past Accepting new patients

Locations

522 Alamosa Ave
Alamosa, CO 81101

8745 County Road 9 S
Alamosa, CO 81101
Phone (719) 587-5612

311 San Juan Ave
Alamosa, CO 81101

14443 US Highway 160
Del Norte, CO 81132

402 4th Ave
Monte Vista, CO 81144

Organizations & group practices 6

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": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1730565417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8745 COUNTY ROAD 9 S",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811019610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 COUNTY ROAD 9 S",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811019610",
            "telephone_number": "719-587-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "ANGELICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamosa, CO

Sources for this page

Verify at the official NPI Registry.