Individual provider Active NPI

Leslie Vornholt

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1891123501
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
991491 Issued in CO
Practice address
4125 47TH St Unit D
Boulder, CO 80301-1761
Phone
(720) 544-7621
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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 991491 CO Primary

Addresses

Primary practice location

4125 47TH St Unit D
Boulder, CO 80301-1761

Mailing address

PO Box 17265
Boulder, CO 80308-0265

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

LicenseStateTypeSpecialty
991491COMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1891123501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17265",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803080265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 47TH ST UNIT D",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011761",
            "telephone_number": "720-544-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VORNHOLT",
        "first_name": "LESLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "991491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.