Robert Collette, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2002030046 Issued in MO

Practice address

12302 Kennedy Dr
Parker, AZ 85344-7833

Phone

(928) 669-5243

NPI assigned

Jul 21, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1154551422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 CAMINO LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035825",
            "telephone_number": "928-453-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12302 KENNEDY DR",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853447833",
            "telephone_number": "928-669-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETTE",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "12469",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2002030046",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Lynn Christensen, RT
• Jared Daniel Christiansen, PA-C
• Scott Clark
• Emily Sue Cobb
• Shelly Lee Coleman, LPN
• Colorado River Family Healthcare, PC
• Colorado River Indian Tribes
• Colorado River Indian Tribes
• Christina Elizabeth Commerford
• Community Intervention Assciates, Inc

• Clinical Social Worker in Parker, AZ
• Providers in Parker, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.