CHARMAYNE N SANDOVAL (LCSW) – Clinical Social Worker, NPI 1215221320

CHARMAYNE N SANDOVAL (LCSW) is a healthcare provider. based in Canon city, Colorado. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. CSW.09923811 (CO). The NPI Number for CHARMAYNE N SANDOVAL (LCSW) is 1215221320

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
CHARMAYNE N SANDOVAL (LCSW)
NPI
1215221320
Phone
(719) 285-2091
Address
1338 Phay Ave Bldg D
Enumeration Date
6 June 2011
Last Update Date
20 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7192852760
Graduation Year
2012 (14 years ago)
PAC ID
8527373760
Group Practice PAC ID
8022927342
Professional Enrollment ID
I20150817001419
Address ID
CO812122326CA1338XAVEX303
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:15State licenses:1Digital endpointsOther names

1,884 CLINICAL SOCIAL WORKER in CO

Provider Addresses for CHARMAYNE N SANDOVAL (LCSW)

  • 1338 Phay Ave Bldg D

    Canon City, CO 812122326

    Phone: (719) 285-2091

    Fax: (719) 285-2092

    Type: Location

  • 300 COLORADO AVE

    PUEBLO, CO 810042006

    Phone: (719) 543-8711

    Fax: (719) 543-0171

    Type: Mailing

  • 110 E ROUTT AVE

    PUEBLO, CO 810042117

    Phone: (719) 543-8711

    Fax: (719) 543-0171

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-08-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150817001419IClinical Social WorkerCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 81212)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8022927342View full group profile
NameSpecialtyState
Physician AssistantCO
Radiation OncologyTX
-CO
Hospitalist, General Practice, Family PracticeCO
Cardiovascular Disease (Cardiology)NM
Family PracticeOK
Internal MedicineCO
-IL
H E M A T O L O G Y/ O N C O L O G YTX
Internal MedicinePA

Reviews

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Frequently asked questions

Can I cross-check CHARMAYNE N SANDOVAL (LCSW) using NPI 1215221320?
NPI 1215221320 belongs to CHARMAYNE N SANDOVAL (LCSW); compare other details if you need extra assurance.
Active or inactive — what applies to CHARMAYNE N SANDOVAL (LCSW)?
You should see CHARMAYNE N SANDOVAL (LCSW) as active in CMS-hosted NPPES data.
What expertise is attributed to CHARMAYNE N SANDOVAL (LCSW)?
CHARMAYNE N SANDOVAL (LCSW)'s specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for CHARMAYNE N SANDOVAL (LCSW)?
Travel planning: use Canon City, Colorado as the reference point for CHARMAYNE N SANDOVAL (LCSW), then confirm.
Can I trust this NPI listing for CHARMAYNE N SANDOVAL (LCSW)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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