Colleen Mack, REGISTERED NURSE

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

RN324249L Issued in PA

Practice address

130 JFK Dr
Suite 132
Atlantis, FL 33462-1141

Phone

(561) 841-6250

NPI assigned

Dec 10, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1376918797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 JFK DR",
            "address_2": "SUITE 132",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621141",
            "telephone_number": "215-303-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 JFK DR",
            "address_2": "SUITE 132",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621141",
            "telephone_number": "561-841-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "COLLEEN",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "PA",
            "license": "RN324249L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyette M Lugo, BS
• Janice Marie Luke, DDS
• Sandra Diane Lyden, M.D.
• Kristal Ashley Lyn
• M&E Concierge FL Inc.
• Ezechiel Madestin, DNP, APRN, PMHNP-BC
• Yoel Madruga Reyes, APRN
• Jay S Maizes, MD
• Kenneth Manchon, MD
• Victor J Mariano Mejia Sr., M.D.

• Adult Psychiatric/Mental Health Registered Nurse in Atlantis, FL
• Providers in Atlantis, FL by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.