Individual provider Active NPI

Audrey Bristol, LCSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1912513698
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09928427 Issued in CO
Practice address
1780 S Bellaire St Ste 485
Denver, CO 80222-4326
Phone
(303) 809-3341
NPI assigned
Sep 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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.09928427 CO Primary

Addresses

Primary practice location

1780 S Bellaire St Ste 485
Denver, CO 80222-4326

Mailing address

3903 Utica St
Denver, CO 80212-2246
Phone (214) 986-4847

Other practice location 1

3903 Utica St
Denver, CO 80212-2246
Phone (214) 986-4847

Other practice location 2

777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220927003904 CO Practitioner - Clinical Social Worker 1850777905 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09928427COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Sep 25, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 25, 2022 Accepting new patients
Julie Reichenberger, Ma, LPC, PLLC PastSince Sep 20, 2020 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

Organizations & group practices 3

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": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1912513698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 UTICA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802122246",
            "telephone_number": "214-986-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 S BELLAIRE ST STE 485",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802224326",
            "telephone_number": "303-809-3341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3903 Utica St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802122246",
            "country_code": "US",
            "telephone_number": "214-986-4847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Bannock St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044597",
            "country_code": "US",
            "telephone_number": "303-436-4200",
            "fax_number": "303-436-4448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRISTOL",
        "first_name": "AUDREY",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.