Individual provider Active NPI

Jenna Quint

  • Clinical Social Worker
  • Pueblo, CO
National Provider Identifier
1912574138
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09929609 Issued in CO
Practice address
1310 Chinook LN
Pueblo, CO 81001-1851
Phone
(719) 545-2746
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X CSW.09929609 CO Primary

Addresses

Primary practice location

1310 Chinook LN
Pueblo, CO 81001-1851

Mailing address

41 Montebello Rd Ste 204
Pueblo, CO 81001-1379

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
I20231003001562 CO Practitioner - Clinical Social Worker 1557715059 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
CSW.09929609COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Health Solutions CurrentSince Aug 30, 2023 Accepting new patients
Health Solutions CurrentSince Aug 30, 2023 Accepting new patients
Health Solutions Current Accepting new patients

Locations

1310 Chinook Ln
Pueblo, CO 81001

1304 Chinook Ln
Pueblo, CO 81001
Phone (719) 562-3222

41 Montebello Rd
Ste 202
Pueblo, CO 81001
Phone (719) 423-1341

41 Montebello Rd
Ste 204
Pueblo, CO 81001
Phone (719) 423-1341

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": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1912574138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MONTEBELLO RD STE 204",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CHINOOK LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011851",
            "telephone_number": "719-545-2746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINT",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09929609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.