Individual provider Active NPI

Justice Riley, LCSW

  • Clinical Social Worker
  • Wheat Ridge, CO
National Provider Identifier
1801410915
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09929582 Issued in CO
Practice address
4643 Wadsworth Blvd
Wheat Ridge, CO 80033-3305
Phone
(303) 425-4480
Fax
(614) 355-8593
NPI assigned
Jun 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 CSW.09929582 CO Primary

Addresses

Primary practice location

4643 Wadsworth Blvd
Wheat Ridge, CO 80033-3305

Mailing address

4851 Independence St
Wheat Ridge, CO 80033-6715
Phone (303) 425-0300

Other identifiers 1

IdentifierTypeStateIssuer
1473276MedicaidOH

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
I20240706000322 CO Practitioner - Clinical Social Worker 9537603162 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Center for Mental Health CurrentSince Apr 12, 2024 Accepting new patients
Children'S Hospital Colorado Clinical Current Accepting new patients
Jefferson Center for Mental Health CurrentSince Apr 12, 2024 Accepting new patients

Locations

16280 W 64th Ave
Arvada, CO 80007
Phone (720) 898-1110

4643 Wadsworth Blvd
Wheat Ridge, CO 80033
Phone (303) 463-7400

4851 Independence St
Wheat Ridge, CO 80033
Phone (303) 432-5115

4851 Independence St
Ste 100
Wheat Ridge, CO 80033
Phone (303) 456-5495

Interoperability endpoints

  • Direct secure messaging: jriley294619@direct.childrenscolorado.org

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": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1801410915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336715",
            "telephone_number": "303-425-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4643 WADSWORTH BLVD",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800333305",
            "telephone_number": "303-425-4480",
            "fax_number": "614-355-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "JUSTICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09929582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473276",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.