| Criston A Menz, LCSW | |
|
408 N Main St Ste F, Rocky Ford, CO 81067-1256 | |
| (719) 423-8834 | |
| (719) 316-2753 |
| Full Name | Criston A Menz |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 408 N Main St Ste F, Rocky Ford, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609484062 | NPI | - | NPPES |
| 14671305 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0009923059 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW.09928454 (Colorado) | Primary |
| Entity Name | Sondermind Provider Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210113002826 |
| Entity Name | Lotusom, Llc |
|---|---|
| Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Entity Identifiers | NPI Number: 1477280576 PECOS PAC ID: 8123401320 Enrollment ID: O20220822001474 |
| Mailing Address | Practice Location Address |
|---|---|
| Criston A Menz, LCSW 1100 Hopkins Ave, Rocky Ford, CO 81067-2421 Ph: (719) 696-0910 | Criston A Menz, LCSW 408 N Main St Ste F, Rocky Ford, CO 81067-1256 Ph: (719) 423-8834 |
Danya Kaytlyn Herrell, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1014 Elm Ave, Rocky Ford, CO 81067 Phone: 719-254-7421 | |
Patrick E Griego, CSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 408 N Main St, Rocky Ford Ste H, Rocky Ford, CO 81067 Phone: 970-703-4824 |