Individual provider Active NPI

Jesse Curtis Bailey, MSW, LCSW, LAC

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1871021865
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09926099 Issued in CO
Practice address
4455 E 12TH Ave
Denver, CO 80220-2415
Phone
(303) 504-7700
NPI assigned
Jun 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0001172 CO
Clinical Social Worker 1041C0700X CSW.09926099 CO Primary

Addresses

Primary practice location

4455 E 12TH Ave
Denver, CO 80220-2415

Mailing address

4455 E 12TH Ave
Denver, CO 80220-2415
Phone (303) 504-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2024 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD.0001172COMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cultivate Life Counseling LLC Addiction (Substance Use Disorder) CurrentSince Mar 26, 2023 Accepting new patients

Locations

1855 S Pearl St
Ste 10
Denver, CO 80210
Phone (720) 277-9854

Organizations & group practices 1

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": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1871021865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "303-504-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "303-504-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "JESSE",
        "middle_name": "CURTIS",
        "credential": "MSW, LCSW, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0001172",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.