Colleen Peddycord, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW021556 Issued in PA

Practice address

3708 5TH Ave Ste 401
Pittsburgh, PA 15213-3427

Phone

(412) 864-2152

NPI assigned

Jun 11, 2019

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

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.

• Upmc Advanced Practice Providers

  • Nurse Practitioner
  • Pittsburgh, PA
  • NPI 1457769176
  Medicare reassignment NPD
• Upmc Advanced Practice Providers

  • Clinical Social Worker
  • Pittsburgh, PA
  • NPI 1720608805
  NPD

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1235798430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 WOODBINE ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152011601",
            "telephone_number": "360-441-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 5TH AVE STE 401",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133427",
            "telephone_number": "412-864-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDDYCORD",
        "first_name": "COLLEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.upmc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3708 5th Ave Ste 401",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152133427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ian William Peck, EMT
• Kelsey Peck
• Margaret Eleanor Peck, DMD
• Havisha Pedamallu, MD, MPH
• Dhiraj Krishna Peddu, M.D.
• Sarah Pedersen, PHD
• William Robert Munk Pedersen, M.D.
• Pediatric & Adult Allergy & Asthma
• Pediatric Alliance, St. Clair Division
• Pediatric Counseling Services LLC

• Clinical Social Worker in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.