Active NPI
Luke Colbourn
- Mental Health Counselor
- Philadelphia, PA
National Provider Identifier
1447865381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R6437
- Practice address
- 1717 Green St Apt 5
Philadelphia, PA 19130-7023 - Phone
- (503) 694-9348
- NPI assigned
- Sep 8, 2020
- Last updated
- Jan 8, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | R6437 | OR | Primary |
Addresses
Primary practice location
1717 Green St Apt 5
Philadelphia, PA 19130-7023
Mailing address
1717 Green St Apt 5
Philadelphia, PA 19130-7023
Phone (503) 694-9348
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
| License | State | Type | Specialty |
|---|---|---|---|
| R6437 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1447865381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 GREEN ST APT 5",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191307023",
"telephone_number": "503-694-9348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 GREEN ST APT 5",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191307023",
"telephone_number": "503-694-9348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBOURN",
"first_name": "LUKE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-08",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R6437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.