Individual provider Active NPI

Mark W Colterjohn, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1356457642
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070239 Issued in NY
Practice address
353 Lexington Ave Ste 300
New York, NY 10016-0941
Phone
(646) 872-5451
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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 070239 NY Primary

Addresses

Primary practice location

353 Lexington Ave Ste 300
New York, NY 10016-0941

Mailing address

672 Fulton St Apt 3B
Brooklyn, NY 11217-1569
Phone (646) 872-5451

Other practice location 1

920 Broadway
8th floor, suite #2
New York, NY 10010-6004
Phone (646) 872-5451

Other practice location 2

672 Fulton St Apt 3B
Brooklyn, NY 11217-1569
Phone (646) 872-5451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20061014000048 NY Practitioner - Clinical Social Worker 1456357433 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

672 Fulton St
Apt 3B
Brooklyn, NY 11217-1569
Phone (646) 872-5451

672 Fulton St Apt
3B
Brooklyn, NY 11217-1569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070239NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nyc Integrative Psychotherapy LCSW PLLC Clinical Current Accepting new patients
Bleuler Psychotherapy Center, Inc. PastSince Mar 10, 1999 Accepting new patients
Gestalt Associates for Psychotherapy Clinical Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1356457642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 FULTON ST APT 3B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171569",
            "telephone_number": "646-872-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 LEXINGTON AVE STE 300",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160941",
            "telephone_number": "646-872-5451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Broadway",
            "address_2": "8th floor, suite #2",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100106004",
            "country_code": "US",
            "telephone_number": "646-872-5451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "672 Fulton St Apt 3B",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112171569",
            "country_code": "US",
            "telephone_number": "646-872-5451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLTERJOHN",
        "first_name": "MARK",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.