Active NPI
Mary Gonnella, LCSW
- Clinical Social Worker
- Thornton, CO
National Provider Identifier
1952701682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 989497
- Practice address
- 9197 Grant St
Suite 100
Thornton, CO 80229-4329 - Phone
- (303) 570-1434
- Fax
- (303) 477-9055
- NPI assigned
- Aug 29, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 989497 | CO | Primary |
Addresses
Primary practice location
9197 Grant St
Suite 100
Thornton, CO 80229-4329
Mailing address
9197 Grant St
Suite 100
Thornton, CO 80229-4329
Phone (303) 570-1434
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 989497 | Other | CO | LICENSE FOR LCSW |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 989497 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409270400000",
"number": "1952701682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9197 GRANT ST",
"address_2": "SUITE 100",
"city": "THORNTON",
"state": "CO",
"postal_code": "802294329",
"telephone_number": "303-570-1434",
"fax_number": "303-477-9055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9197 GRANT ST",
"address_2": "SUITE 100",
"city": "THORNTON",
"state": "CO",
"postal_code": "802294329",
"telephone_number": "303-570-1434",
"fax_number": "303-477-9055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONNELLA",
"first_name": "MARY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-29",
"last_updated": "2014-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "989497",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE FOR LCSW",
"identifier": "989497",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.