Larry Willis Colston, LMSW,ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801034096 Issued in MI

Practice address

10 Peterboro St
Detroit, MI 48201-2722

Phone

(313) 831-3160

Fax

(313) 831-2604

NPI assigned

Oct 26, 2006

Last updated

May 25, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Larry Willis Colston Professional name

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.

• Care Continuum, Inc.

  dba Heritage Care Group

  • Mental Health Counselor
  • Southfield, MI
  • NPI 1508920331
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1033294947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PETERBORO ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012722",
            "telephone_number": "313-831-3160",
            "fax_number": "313-831-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PETERBORO ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012722",
            "telephone_number": "313-831-3160",
            "fax_number": "313-831-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLSTON",
        "first_name": "LARRY",
        "middle_name": "WILLIS",
        "name_prefix": "Mr.",
        "credential": "LMSW,ACSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801034096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARRY",
            "last_name": "COLSTON",
            "middle_name": "WILLIS",
            "prefix": "MR.",
            "credential": "LMSW,ACSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Pino D. Colone, M.D.
• David A Colosimo, M.D.
• Denise Colson
• Glendoria Colson, MS, LLPC
• Natalie Mae Colson, PA-C
• Stephanie Colton, DNP
• Nyla Colvard
• Teri Laurie Colvin
• Aissatou Gnima Coly
• Nicole Comer

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.