Marion Gamble McCollum, ED.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

895 Issued in NC

Practice address

912 N. Elm St.
Greensboro, NC 27401-1513

Phone

(336) 274-4669

Fax

(336) 274-4749

NPI assigned

Jan 10, 2006

Last updated

Nov 10, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Carolina Psychological Associates, P.a.

  • Counseling Psychologist
  • Greensboro, NC
  • NPI 1467409003

  Clinical

  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1033198841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 N. ELM ST.",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011513",
            "telephone_number": "336-274-4669",
            "fax_number": "336-274-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 N. ELM ST.",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011513",
            "telephone_number": "336-274-4669",
            "fax_number": "336-274-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "MARION",
        "middle_name": "GAMBLE",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "895",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Thomas McClung, MD
• Sarah Yacobi McClung, PA-C
• William T McClure, MS, CWCE, CEES
• Eric Jay McCollum, DDS
• Kathleen Savannah McCollum
• Shikea L McCollum, MSW, LCSWA
• Whitney McCollum
• John S McComb, M.D.
• Rosanna Carol McConnell, MD
• Haley Dane McCord, LCSWA

• Clinical Psychologist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.