Individual provider Active NPI

Becky Darlene Avery, MDIV, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1780823732
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1842 Issued in CO
Practice address
1426 N Hancock Ave
Suite 5N
Colorado Springs, CO 80903-2618
Phone
(719) 331-7445
NPI assigned
Feb 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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 1842 CO Primary

Addresses

Primary practice location

1426 N Hancock Ave
Suite 5N
Colorado Springs, CO 80903-2618

Mailing address

2316 N Wahsatch Ave
#240
Colorado Springs, CO 80907-6968
Phone (719) 331-7445

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
1842COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1234742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1780823732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 N WAHSATCH AVE",
            "address_2": "#240",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076968",
            "telephone_number": "719-331-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 N HANCOCK AVE",
            "address_2": "SUITE 5N",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032618",
            "telephone_number": "719-331-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "BECKY",
        "middle_name": "DARLENE",
        "name_prefix": "Ms.",
        "credential": "MDIV, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-16",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1842",
            "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 Dec 15, 2015; 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.