Active NPI
Jennifer Grace Koch, LCSW
- Clinical Social Worker
- Denver, CO
National Provider Identifier
1740468826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW.00000636
- Practice address
- 4495 Hale Pkwy Ste 307
Denver, CO 80220-6204 - Phone
- (720) 234-8163
- NPI assigned
- Jan 31, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW.00000636 | CO | Primary |
Addresses
Primary practice location
4495 Hale Pkwy Ste 307
Denver, CO 80220-6204
Mailing address
4495 Hale Pkwy Ste 307
Denver, CO 80220-6204
Phone (720) 234-8163
Other practice location 1
777 Bannock St
Denver, CO 80204-4597
Phone (303) 602-8990
Other practice location 2
1001 Yosemite St
Denver, CO 80230-6074
Phone (303) 436-7433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 18, 2024 through Jun 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW.00000636 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1740468826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4495 HALE PKWY STE 307",
"city": "DENVER",
"state": "CO",
"postal_code": "802206204",
"telephone_number": "720-234-8163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4495 HALE PKWY STE 307",
"city": "DENVER",
"state": "CO",
"postal_code": "802206204",
"telephone_number": "720-234-8163"
}
],
"practiceLocations": [
{
"address_1": "777 Bannock St",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802044597",
"country_code": "US",
"telephone_number": "303-602-8990",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1001 Yosemite St",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802306074",
"country_code": "US",
"telephone_number": "303-436-7433",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOCH",
"first_name": "JENNIFER",
"middle_name": "GRACE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-31",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW.00000636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.