Individual provider Active NPI

Collin Heller, APSW

  • Social Worker
  • Sun Prairie, WI
National Provider Identifier
1396441374
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
133026 Issued in WI
Practice address
722 Lois Dr
Sun Prairie, WI 53590-1100
Phone
(608) 837-9112
NPI assigned
Feb 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 133026 WI Primary

Addresses

Primary practice location

722 Lois Dr
Sun Prairie, WI 53590-1100

Mailing address

17 S River St Ste 254
Janesville, WI 53548-3863

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
133026WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trivium LLC CurrentSince Feb 8, 2023 Accepting new patients
Trivium LLC PastSince Feb 8, 2023 Accepting new patients

Locations

17 S River St
Ste 254
Janesville, WI 53548
Phone (608) 755-5260

722 Lois Dr
Sun Prairie, WI 53590
Phone (608) 755-5260

Organizations & group practices 2

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1396441374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 S RIVER ST STE 254",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 LOIS DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901100",
            "telephone_number": "608-837-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "COLLIN",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "133026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.