Gregory L MC Collough, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW001591 Issued in GA

Practice address

115 Martin Luther King Jr Dr SW
Suite 277
Atlanta, GA 30303-3536

Phone

(404) 730-0230

Fax

(404) 730-0341

NPI assigned

Aug 1, 2006

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376550525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 MILL ACRES DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303113216",
            "telephone_number": "404-730-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MARTIN LUTHER KING JR DR SW",
            "address_2": "SUITE 277",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033536",
            "telephone_number": "404-730-0230",
            "fax_number": "404-730-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MC COLLOUGH",
        "first_name": "GREGORY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Atlanta, GA
• Providers in Atlanta, 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 8, 2007; 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.