Individual provider Active NPI

Barbara L Colombo-Clague, LCSW-R ,ACSW

  • Clinical Social Worker
  • Dix Hills, NY
National Provider Identifier
1144656372
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R042844-1 Issued in NY
Practice address
151 Burrs Lane
Dix Hills, NY 11746
Phone
(631) 253-3480
Fax
(631) 253-3483
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R042844-1 NY Primary

Addresses

Primary practice location

151 Burrs Lane
Dix Hills, NY 11746

Mailing address

151 Burrs Lane
Dix Hills, NY 11746
Phone (631) 253-3480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20140424000052 NY Practitioner - Clinical Social Worker 9436382678 Reassigns benefits to 1 organization
Practice locations: Commack, NY; Plainview, NY; Smithtown, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21 Redwood LN
Smithtown, NY 11787-2718
Phone (516) 864-6586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R042844-1NYMDClinical Social Worker
042844NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sco Family of Services Dba Madonna Heights Service Clinic CurrentSince Sep 10, 2013 Accepting new patients

Locations

151 Burrs Ln
Dix Hills, NY 11746
Phone (631) 213-0146

1415 Kellum Pl
Ste 140
Garden City, NY 11530
Phone (516) 671-1253

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1144656372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 BURRS LANE",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "11746",
            "telephone_number": "631-253-3480",
            "fax_number": "631-253-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 BURRS LANE",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "11746",
            "telephone_number": "631-253-3480",
            "fax_number": "631-253-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOMBO-CLAGUE",
        "first_name": "BARBARA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW-R  ,ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R042844-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.