Stacy Colgan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.015514 Issued in IL

Practice address

2245 Woodland Cir
Naperville, IL 60565-3213

Phone

(630) 740-2551

NPI assigned

Apr 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Watervliet Counseling PLLC

  • Adult Mental Health Clinic/Center
  • Naperville, IL
  • NPI 1740954106
  NPD Authorized official

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1235712092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 WOODLAND CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605653213",
            "telephone_number": "630-740-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 WOODLAND CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605653213",
            "telephone_number": "630-740-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLGAN",
        "first_name": "STACY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-08-08",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomiya Cole
• Deborah K Coleman, MD
• Erica Coleman
• Katie Lynn Coleman, RDH
• Jacqueline Anne Coler-Malesich, RPH
• Mindy Colgrove, MD
• Collaboration Practices, PLLC
• Collaborative Consulting LLC
• Carissa Collado
• Kenneth Jay Collen, DDS

• Clinical Social Worker in Naperville, IL
• Providers in Naperville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2021; 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.