Colleen Mary Mortell, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2035-057 Issued in WI

Practice address

2727 Marshall CT
Madison, WI 53705-2255

Phone

(608) 238-9354

Fax

(608) 238-7675

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Psychologist

Education

University of Mississippi School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychiatric Services SCGroup PAC ID 4789656083, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Psychiatric Services SC

  • Psychiatry Physician
  • Madison, WI
  • NPI 1902098957
  Medicare reassignment Care Compare group NPD
• Madison Psychiatric Associates, LTD.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Middleton, WI
  • NPI 1821026550

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1194814269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 MARSHALL CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052255",
            "telephone_number": "608-238-9354",
            "fax_number": "608-238-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 MARSHALL CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052255",
            "telephone_number": "608-238-9354",
            "fax_number": "608-238-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTELL",
        "first_name": "COLLEEN",
        "middle_name": "MARY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2035",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2035-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39712000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Ashlee Morrison, DMD
• Mikaela Marie Morrison, PA
• Steven Morrison, MD
• Donna M Morrissey, LPC
• Jonathan Morse
• Brooke Mortensen, NP
• Sean Mortenson
• Wendy R Mortimore, MD
• Timothy J Morton, PA-C
• Caitlin Mory, APSW

• Psychologist in Madison, WI
• Providers in Madison, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.