Active NPI
Samuel Max Colbert, PHD
- Counseling Psychologist
- Philadelphia, PA
National Provider Identifier
1295433498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PS019831
- Practice address
- 123 S Broad St Ste 2240
Philadelphia, PA 19109-1029 - Phone
- (267) 571-9861
- NPI assigned
- Feb 17, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PS019831 | PA | Primary |
Addresses
Primary practice location
123 S Broad St Ste 2240
Philadelphia, PA 19109-1029
Mailing address
123 S Broad St Ste 2240
Philadelphia, PA 19109-1029
Phone (267) 571-9861
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS019831 | PA | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colbert Psychotherapy & Consulting, Inc. | Counseling | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Counseling Psychologist
- Philadelphia, PA
- NPI 1306724430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676592000000",
"number": "1295433498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 S BROAD ST STE 2240",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191091029",
"telephone_number": "267-571-9861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 S BROAD ST STE 2240",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191091029",
"telephone_number": "267-571-9861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBERT",
"first_name": "SAMUEL",
"middle_name": "MAX",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-17",
"last_updated": "2023-02-17",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PA",
"license": "PS019831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.