Karl M Ingram

Individual provider Active NPI Clinical Social Worker · Burlington, CO

NPI 1821657784 · NPPES record last updated Jun 15, 2021

Key facts

NPI
1821657784
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
CSW.09927460 (CO)
Practice address
1291 Circle Dr
Burlington, CO 80807-1245
Phone
(719) 346-8183
Fax
(719) 346-0292
NPI assigned
Jun 13, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X CSW.09927460 CO Yes

Addresses

Primary practice location

1291 Circle Dr
Burlington, CO 80807-1245

Mailing address

211 W Main St
Sterling, CO 80751-3168
Phone (970) 522-4549

Other providers in Burlington, CO

All providers in Burlington, CO · Clinical Social Worker in Colorado

Sources for this page

Verify at the official NPI Registry.