Colleen L Hagan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

001379 Issued in GA

Practice address

1640 Powers Ferry Rd
BLDG 29, Ste 350
Marietta, GA 30067-5491

Phone

(770) 956-9212

Fax

(770) 956-9218

NPI assigned

Jan 14, 2006

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Psychological Source, Inc.

  • Clinical Social Worker
  • Marietta, GA
  • NPI 1740421163
  NPD (past)

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

{
    "created_epoch": "1137196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295714442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD",
            "address_2": "BLDG 29, STE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-956-9212",
            "fax_number": "770-956-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 POWERS FERRY RD",
            "address_2": "BLDG 29, STE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675491",
            "telephone_number": "770-956-9212",
            "fax_number": "770-956-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "COLLEEN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "001379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shana Boyd Hackworth, PHYSICIAN ASSISTANT
• Jeremy Eric Hadibe, DDS
• Charles R Haendel, DPM
• Joseph Vance Haezebrouck, D.C.
• David H. Hafner, M.D.
• Terris Leigh Hagan
• Miah J Hagans, MD, MPH
• Kazem Haghir Ebrahimabadi, RPH
• Murl Felton Hagood, MD
• Hillary A Hahm, MD, PHD

• Clinical Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.