NPIMap

Individual provider Active NPI

Shelley Tanen, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1760635262
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
993056 Issued in CO
Practice address
823 N Prospect St
Colorado Springs, CO 80903-2825
Phone
(719) 634-6107
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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 993056 CO Primary

Addresses

Primary practice location

823 N Prospect St
Colorado Springs, CO 80903-2825

Mailing address

823 N Prospect St
Colorado Springs, CO 80903-2825
Phone (719) 634-6107

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
993056COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rementis Health Group LLC Past Accepting new patients
Memory Bridging Incorporated Past Accepting new patients
Springs Counseling Center Past Accepting new patients

Organizations & group practices 3

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1760635262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 N PROSPECT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032825",
            "telephone_number": "719-634-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 N PROSPECT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032825",
            "telephone_number": "719-634-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANEN",
        "first_name": "SHELLEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "993056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.