Active NPI
Melissa King, LCSW
- Clinical Social Worker
- Pueblo, CO
National Provider Identifier
1770131310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW.09928705
- Practice address
- 1711 E Evans Ave
Pueblo, CO 81004-3349 - Phone
- (719) 404-1784
- NPI assigned
- Aug 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
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.09928705 | CO | Primary |
Addresses
Primary practice location
1711 E Evans Ave
Pueblo, CO 81004-3349
Mailing address
1711 E Evans Ave
Pueblo, CO 81004-3349
Phone (719) 404-1784
Other practice location 1
777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4949
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230802003925 | CO | Practitioner - Clinical Social Worker | 6800257189 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW.09928705 | CO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Denver Health and Hospital Authority | Current | Accepting new patients |
Locations
777 Bannock St
Denver, CO 80204
Organizations & group practices 2
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.
-
- Psychiatric Hospital Unit
- Denver, CO
- NPI 1689624942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1770131310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 E EVANS AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810043349",
"telephone_number": "719-404-1784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1711 E EVANS AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810043349",
"telephone_number": "719-404-1784"
}
],
"practiceLocations": [
{
"address_1": "777 Bannock St",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802044597",
"country_code": "US",
"telephone_number": "303-436-4949",
"fax_number": "303-436-4610",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KING",
"first_name": "MELISSA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-27",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW.09928705",
"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 Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.