Individual provider Active NPI

Abigail Lynn Kubicek, LCSW

  • Clinical Social Worker
  • Durango, CO
National Provider Identifier
1891304937
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09926731 Issued in CO
Practice address
100 Jenkins Ranch Rd Unit E1
Durango, CO 81301-9473
Phone
(970) 403-5663
Fax
(970) 764-4049
NPI assigned
Jul 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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.09926731 CO Primary

Addresses

Primary practice location

100 Jenkins Ranch Rd Unit E1
Durango, CO 81301-9473

Mailing address

1140 Carbon JCT Apt 38
Durango, CO 81301-3424
Phone (720) 988-3487

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
CSW.09926731COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Higher, Inc. Clinical CurrentSince Aug 2, 2020 Accepting new patients

Locations

100 Jenkins Ranch Rd
Unit E1
Durango, CO 81301
Phone (970) 422-3830

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": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1891304937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 CARBON JCT APT 38",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813013424",
            "telephone_number": "720-988-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JENKINS RANCH RD UNIT E1",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813019473",
            "telephone_number": "970-403-5663",
            "fax_number": "970-764-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICEK",
        "first_name": "ABIGAIL",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.