Active NPI
Melvin Francis Betancourt, MSW
- Clinical Social Worker
- Edwards, CO
National Provider Identifier
1982837597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 09924430
- Practice address
- 320 Beard Creek Rd
Edwards, CO 81632 - Phone
- (970) 945-2840
- Fax
- (970) 945-2893
- NPI assigned
- Aug 30, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | 09924430 | CO | Primary |
Addresses
Primary practice location
320 Beard Creek Rd
Edwards, CO 81632
Mailing address
2700 Gilstrap CT Ste 230
Glenwood Springs, CO 81601-8735
Phone (970) 945-2840
Other practice location 1
850 West Beaver Creek Blvd
Avon, CO 81620
Phone (970) 945-2840
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09924430 | Other | CO | COLORADO LICENSE |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09924430 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591833600000",
"number": "1982837597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 GILSTRAP CT STE 230",
"city": "GLENWOOD SPRINGS",
"state": "CO",
"postal_code": "816018735",
"telephone_number": "970-945-2840",
"fax_number": "970-945-2893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 BEARD CREEK RD",
"city": "EDWARDS",
"state": "CO",
"postal_code": "81632",
"telephone_number": "970-945-2840",
"fax_number": "970-945-2893"
}
],
"practiceLocations": [
{
"address_1": "850 West Beaver Creek Blvd",
"address_purpose": "LOCATION",
"city": "Avon",
"state": "CO",
"postal_code": "81620",
"country_code": "US",
"telephone_number": "970-945-2840",
"fax_number": "970-945-2893",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BETANCOURT",
"first_name": "MELVIN",
"middle_name": "FRANCIS",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-30",
"last_updated": "2020-06-11",
"certification_date": "2020-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "09924430",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLORADO LICENSE",
"identifier": "09924430",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edwards, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.