Individual provider Active NPI

Colin O McEntee, LCSW

  • Clinical Social Worker
  • University Park, PA
National Provider Identifier
1194067553
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW024119 Issued in PA
Practice address
314 Moore BLDG
University Park, PA 16802
Phone
(814) 865-2191
NPI assigned
Mar 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904009962 VA
Clinical Social Worker 1041C0700X CW024119 PA Primary

Addresses

Primary practice location

314 Moore BLDG
University Park, PA 16802

Mailing address

405 N 5TH St
Philipsburg, PA 16866-2324
Phone (804) 878-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231218001313 PA Practitioner - Clinical Social Worker 3173880895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

138 Fischer Rd
University Park, PA 16802-4604
Phone (814) 865-2191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW024119PAMDClinical Social Worker
0904009962VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Pennsylvania State University CurrentSince Nov 15, 2023 Accepting new patients
The Pennsylvania State University CurrentSince Nov 15, 2023 Accepting new patients

Organizations & group practices 2

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": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1194067553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N 5TH ST",
            "city": "PHILIPSBURG",
            "state": "PA",
            "postal_code": "168662324",
            "telephone_number": "804-878-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 MOORE BLDG",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "16802",
            "telephone_number": "814-865-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCENTEE",
        "first_name": "COLIN",
        "middle_name": "O",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009962",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW024119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, PA

Sources for this page

Verify at the official NPI Registry.