Individual provider Active NPI

Phyllis Schechtman, LCSW

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1972136687
Registry record updated Feb 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09924677 Issued in CO
Practice address
777 29TH St Ste 500
Boulder, CO 80303-2357
Phone
(845) 243-1452
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 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 09924677 CO Primary

Addresses

Primary practice location

777 29TH St Ste 500
Boulder, CO 80303-2357

Mailing address

777 29TH St
Boulder, CO 80303-2358
Phone (845) 243-1452

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
I20240507000839 CO Practitioner - Clinical Social Worker 2466892542

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

215 W Oak St
FL 4
Fort Collins, CO 80521-2734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09924677COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Centered Counseling, PC Clinical Current Accepting new patients
Jewish Family Service of Colorado PastSince Aug 6, 2023 Accepting new patients
Jewish Family Service of Colorado PastSince Oct 1, 2022 Accepting new patients

Locations

215 W Oak St
Fl 4
Fort Collins, CO 80521
Phone (253) 346-1331

1630 Dry Creek Dr
Ste 100-B
Longmont, CO 80503
Phone (913) 244-3563

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707609600000",
    "number": "1972136687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 29TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032358",
            "telephone_number": "845-243-1452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 29TH ST STE 500",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032357",
            "telephone_number": "845-243-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHECHTMAN",
        "first_name": "PHYLLIS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2024-02-11",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09924677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.