Matthew Banach, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09925288 Issued in CO

Practice address

105 S Main St
Fountain, CO 80817-2215

Phone

(719) 217-4609

NPI assigned

Mar 21, 2019

Last updated

Aug 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Frontiers Counseling LLC

  • Clinical Social Worker
  • Fountain, CO
  • NPI 1194577098
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1891255253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S MAIN ST",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808172215",
            "telephone_number": "719-217-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S MAIN ST",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808172215",
            "telephone_number": "719-217-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANACH",
        "first_name": "MATTHEW",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen B Arreola
• Perry Bernard Bach, M.D.
• Rayelle Irene Bailey
• Maliek Baldwin-Brown
• Seth Dean Baldwin, OD
• Analiese Barnes
• Aileen Barnett
• Shayna Barnhart, DPT
• Olyvia Anne Beard
• Taylor Behnke, PHARMD

• Clinical Social Worker in Fountain, CO
• Providers in Fountain, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.