NPIMap

Individual provider Active NPI

James Bryan McCollom, LCSW-C

  • Clinical Social Worker
  • Columbia, MD
National Provider Identifier
1275751711
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06538 Issued in MD
Practice address
8930 Stanford Blvd.
Columbia, MD 21046
Phone
(410) 313-6202
Fax
(410) 313-6212
NPI assigned
Apr 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 06538 MD Primary

Addresses

Primary practice location

8930 Stanford Blvd.
Columbia, MD 21046

Mailing address

8930 Stanford Blvd.
Columbia, MD 21045
Phone (410) 313-6202

Other names 1

  • Mr. Bryan McCollom Professional name

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

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1275751711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 STANFORD BLVD.",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21045",
            "telephone_number": "410-313-6202",
            "fax_number": "410-313-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 STANFORD BLVD.",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21046",
            "telephone_number": "410-313-6202",
            "fax_number": "410-313-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLOM",
        "first_name": "JAMES",
        "middle_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "06538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYAN",
            "last_name": "MCCOLLOM",
            "prefix": "MR.",
            "credential": "LCSW-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.