Individual provider Active NPI

Kelly Todd Stohl, LCSW

  • Clinical Social Worker
  • Aurora, CO
National Provider Identifier
1962466821
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
739 Issued in CO
Practice address
3263 Fraser St
Suite 3
Aurora, CO 80011-1217
Phone
(303) 371-1000
Fax
(303) 371-1002
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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 739 CO Primary

Addresses

Primary practice location

3263 Fraser St
Suite 3
Aurora, CO 80011-1217

Mailing address

3263 Fraser St Ste 3
Aurora, CO 80011-1245
Phone (303) 371-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 24, 2017 through Jan 24, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
739COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Four Corners Community Behavioral Health, Inc. PastSince Apr 6, 2015 Accepting new patients
Four Corners Community Behavioral Health Inc Past Accepting new patients
LDS Family Services Past Accepting new patients

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1962466821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3263 FRASER ST STE 3",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800111245",
            "telephone_number": "303-371-1000",
            "fax_number": "303-371-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3263 FRASER ST",
            "address_2": "SUITE 3",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800111217",
            "telephone_number": "303-371-1000",
            "fax_number": "303-371-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOHL",
        "first_name": "KELLY",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.