Individual provider Active NPI

Colette A Reid Horn, MSW, LCSW

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1174796924
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS73565 Issued in CA
Practice address
610 Mount Vernon Ave
San Francisco, CA 94112-2424
Phone
(510) 545-9019
NPI assigned
Apr 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS73565 CA Primary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 73565 CA

Addresses

Primary practice location

610 Mount Vernon Ave
San Francisco, CA 94112-2424

Mailing address

610 Mount Vernon Ave
San Francisco, CA 94112-2424
Phone (510) 545-9019

Other practice location 1

3301 E 12th St
Suite 259
Oakland, CA 94601-3424
Phone (510) 269-9030

Other identifiers 1

IdentifierTypeStateIssuer
14645639OtherCACAQH ID

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL hello@hornwellness.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
73565CAMDClinical Social Worker
LCS73565CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Horn Optimal Wellness Services, Inc. - a Professional LCSW Corporation CurrentSince Aug 28, 2022 Accepting new patients

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": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1174796924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 MOUNT VERNON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941122424",
            "telephone_number": "510-545-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 MOUNT VERNON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941122424",
            "telephone_number": "510-545-9019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 E 12th St",
            "address_2": "Suite 259",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946013424",
            "country_code": "US",
            "telephone_number": "510-269-9030",
            "fax_number": "510-269-9031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID HORN",
        "first_name": "COLETTE",
        "middle_name": "A",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS73565",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "73565",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "14645639",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "hello@hornwellness.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work email",
            "address_1": "610 Mount Vernon Ave",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941122424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.