Individual provider Active NPI

Kristyna Maria Irene Smith

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1821789876
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09930993 Issued in CO
Practice address
4141 E Dickenson PL
Denver, CO 80222-6012
Phone
(303) 504-3988
NPI assigned
May 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 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.09930993 CO Primary

Addresses

Primary practice location

4141 E Dickenson PL
Denver, CO 80222-6012

Mailing address

4141 E Dickenson PL
Denver, CO 80222-6012
Phone (303) 504-3966

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
I20241101000066 CO Practitioner - Clinical Social Worker 8820521628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Center of DenverGroup PAC ID 3476440314, 87 clinicians

Practice addresses (Care Compare)

4141 E Dickenson PL
Denver, CO 80222-6012
Phone (303) 504-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09930993COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of Denver Current Accepting new patients
Mental Health Center of Denver CurrentSince Sep 30, 2024 Accepting new patients
Mental Health Center of Denver PastSince May 1, 2023 Accepting new patients

Locations

4353 E Colfax Ave
Denver, CO 80220
Phone (303) 504-1200

4141 E Dickenson Pl
Denver, CO 80222
Phone (303) 504-6509

1610 N Emerson St
Denver, CO 80218
Phone (303) 504-3988

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": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1821789876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 E DICKENSON PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226012",
            "telephone_number": "303-504-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 E DICKENSON PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226012",
            "telephone_number": "303-504-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTYNA",
        "middle_name": "MARIA IRENE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09930993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.