NPIMap

Organization Active NPI

Colleen Vernold, LCSW-R Counseling Services

  • Clinical Social Worker
  • Rome, NY
National Provider Identifier
1487307211
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
COLLEEN VERNOLD, LCSW-R COUNSELING SERVICES
Doing business as
Colleen Vernold, LCSW-R Counseling Services
Practice address
6676 Potter Rd
Rome, NY 13440-2016
Phone
(315) 741-5586
NPI assigned
Feb 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Colleen Vernold, LCSW-RNPI 1134232705
Title
Owner
Phone
(315) 741-5586

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6676 Potter Rd
Rome, NY 13440-2016

Mailing address

6676 Potter Rd
Rome, NY 13440-2016
Phone (315) 741-5586

Other identifiers 1

IdentifierTypeStateIssuer
J300287089MedicaidNY

Other names 1

  • Colleen Vernold, LCSW-R Counseling Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ColleenVernold@iTherapymail.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1487307211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6676 POTTER RD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402016",
            "telephone_number": "315-741-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6676 POTTER RD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402016",
            "telephone_number": "315-741-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEEN VERNOLD, LCSW-R COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "VERNOLD",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-741-5586",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "J300287089",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ColleenVernold@iTherapymail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6676 Potter Rd",
            "city": "Rome",
            "state": "NY",
            "country_code": "US",
            "postal_code": "134402016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Colleen Vernold, LCSW-R Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.