Active NPI
Diane C Burroughs, LCSW, LSCSW
- Clinical Social Worker
- Colorado Springs, CO
National Provider Identifier
1891107603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW00989646
- Practice address
- 3555 Cranswood Way
Colorado Springs, CO 80918-6339 - Phone
- (719) 650-0812
- NPI assigned
- May 28, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW00989646 | CO | Primary |
| Clinical Social Worker | 1041C0700X | 1056 | KS |
Addresses
Primary practice location
3555 Cranswood Way
Colorado Springs, CO 80918-6339
Mailing address
3555 Cranswood Way
Colorado Springs, CO 80918-6339
Phone (719) 650-0812
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 451657851 | Other | CO | FEIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW00989646 | CO | MD | Clinical Social Worker |
| 1056 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401235200000",
"number": "1891107603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3555 CRANSWOOD WAY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809186339",
"telephone_number": "719-650-0812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 CRANSWOOD WAY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809186339",
"telephone_number": "719-650-0812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURROUGHS",
"first_name": "DIANE",
"middle_name": "C",
"credential": "LCSW, LSCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-28",
"last_updated": "2014-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW00989646",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "1056",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEIN",
"identifier": "451657851",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.