Active NPI
Sophie McCollum, LCSW
- Clinical Social Worker
- Houston, TX
National Provider Identifier
1306296504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 55452
- Practice address
- 5311 Kirby Dr
Suite 204
Houston, TX 77005-1364 - Phone
- (713) 997-0766
- NPI assigned
- Jun 17, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 55452 | TX | Primary |
Addresses
Primary practice location
5311 Kirby Dr
Suite 204
Houston, TX 77005-1364
Mailing address
843 Jaquet Dr
Bellaire, TX 77401-2814
Phone (713) 997-0766
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55452 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466121600000",
"number": "1306296504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "843 JAQUET DR",
"city": "BELLAIRE",
"state": "TX",
"postal_code": "774012814",
"telephone_number": "713-997-0766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5311 KIRBY DR",
"address_2": "SUITE 204",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770051364",
"telephone_number": "713-997-0766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOLLUM",
"first_name": "SOPHIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-17",
"last_updated": "2016-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "55452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.