Kawana (Kay) Collake, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8400 Issued in TN

Practice address

403 Princeton Rd Ste 2
Johnson City, TN 37601-2040

Phone

(423) 741-5644

Fax

(423) 714-3116

NPI assigned

Mar 28, 2023

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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, TN

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  TN

  Medicare reassignment NPD

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1114621828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 PRINCETON RD STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012040",
            "telephone_number": "423-741-5644",
            "fax_number": "423-714-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PRINCETON RD STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012040",
            "telephone_number": "423-741-5644",
            "fax_number": "423-714-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAKE",
        "first_name": "KAWANA (KAY)",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "8400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Marie Cole, CRNA
• Anthony Thad Cole
• Judith Leggett Cole, LCSW
• Cole'S Medical Services LLC (Cole's Medical Services)
• Cynthia M Coletti, MD
• Collart Chiropractic LLC
• Molly Kristen Colley, LPC-MHSP
• Christin Collie, PH.D.
• Mary Elizabeth Collier, PMHNP-BC
• April Starr Collins, LCSW

• Clinical Social Worker in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.