Individual provider Active NPI

Lisa Casperson

  • Clinical Social Worker
  • Fort Collins, CO
National Provider Identifier
1801321047
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9930224 Issued in CO
Practice address
2850 McClelland Dr Ste 3400
Fort Collins, CO 80525-2572
Phone
(866) 285-2929
Fax
(208) 567-5844
NPI assigned
Apr 25, 2017
Last updated
Jul 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Clinical Social Worker 1041C0700X 9930224 CO Primary

Addresses

Primary practice location

2850 McClelland Dr Ste 3400
Fort Collins, CO 80525-2572

Mailing address

155 S Madison St Ste 306
Denver, CO 80209-3014
Phone (970) 576-1717

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
I20240506000432 CO Practitioner - Clinical Social Worker 9739529918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9930224COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Polaris Partners Counseling and Consulting LLC CurrentSince Mar 25, 2024 Accepting new patients
Polaris Partners Counseling and Consulting LLC Clinical CurrentSince Mar 25, 2024 Accepting new patients
Polaris Partners Counseling and Consulting LLC Clinical Past Accepting new patients

Locations

155 S Madison St
Ste 306
Denver, CO 80209
Phone (970) 576-1717

2850 McClelland Dr
Ste 3400
Fort Collins, CO 80525
Phone (303) 345-8004

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1801321047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S MADISON ST STE 306",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093014",
            "telephone_number": "970-576-1717",
            "fax_number": "208-567-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 MCCLELLAND DR STE 3400",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252572",
            "telephone_number": "866-285-2929",
            "fax_number": "208-567-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASPERSON",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "9930224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.