Diane Pukajlo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09925846 Issued in CO

Practice address

3237 W Carefree Cir
Colorado Springs, CO 80917-3004

Phone

(719) 271-2496

NPI assigned

Mar 20, 2007

Last updated

Mar 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  CO

  Medicare reassignment NPD
• Restoring You Therapy

  • Clinical Social Worker
  • Colorado Springs, CO
  • NPI 1336703107
  NPD Authorized official
• SPN Government LLC

  • Clinical Social Worker
  • Aurora, CO
  • NPI 1154984680
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1982729927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16825 GUADALUPE CT",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808319452",
            "telephone_number": "719-482-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 W CAREFREE CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809173004",
            "telephone_number": "719-271-2496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Chinook Ln",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810011851",
            "country_code": "US",
            "telephone_number": "719-545-2746",
            "fax_number": "719-584-0119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUKAJLO",
        "first_name": "DIANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09925846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pueblo Radiological Group, P.C.
• Noelia Puga
• Daniel James Pugh
• Nathan Neil Pughe, L.AC.
• Samantha Puissant
• Hailey Pukansky
• James A Pulciani, A.P., C.M.T.
• Elizabeth Pulliam
• Pulmonary Associates
• Christina Brooke Pulz, LPC

• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.