Teri Lynn Collet, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS15675 Issued in CA

Practice address

2490 W Shaw Ave Ste 101
Fresno, CA 93711-3063

Phone

(209) 681-5226

NPI assigned

Oct 10, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Teri Lynn Crilly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1104253046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5032 TREETOP DR.",
            "city": "SALIDA",
            "state": "CA",
            "postal_code": "95368",
            "telephone_number": "209-681-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 W SHAW AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113063",
            "telephone_number": "209-681-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLET",
        "first_name": "TERI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-10",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS15675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERI",
            "last_name": "CRILLY",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taria Coleman
• Sierra McKayla Colis
• Patricia Collamer
• Jordon Eugene Collazo, EMT
• Collegium Scientifica
• Wildren Anthony Collette, COUNSELOR
• Phillip Martin Collier, PH D
• Ana J Collins
• Atif Collins, M.D.
• Chandler Collins

• Clinical Social Worker in Fresno, CA
• Providers in Fresno, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.