Individual provider Active NPI

Eva Kai Klemens, LCSW

  • Clinical Social Worker
  • Lafayette, CO
National Provider Identifier
1962627935
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
947 Issued in CO
Practice address
1400 Dixon St
Lafayette, CO 80026-2790
Phone
(303) 926-6459
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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 947 CO Primary

Addresses

Primary practice location

1400 Dixon St
Lafayette, CO 80026-2790

Mailing address

1400 Dixon Avenue
Lafayette, CO 80026-2790
Phone (303) 926-6459

Other identifiers 2

IdentifierTypeStateIssuer
947OtherCOLCSW
178OtherCOLICENSE

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
947COMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Developmental Disabilities Center Clinical CurrentSince Aug 11, 2006 Accepting new patients
Developmental Disabilities Center CurrentSince Aug 11, 2006 Accepting new patients

Locations

1400 Dixon Ave
Lafayette, CO 80026
Phone (303) 457-5719

Organizations & group practices 2

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1962627935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DIXON AVENUE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262790",
            "telephone_number": "303-926-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 DIXON ST",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262790",
            "telephone_number": "303-926-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMENS",
        "first_name": "EVA",
        "middle_name": "KAI",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "947",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "178",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.