Clarissa Colley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

53506 Issued in TX

Practice address

3804 Avenue B
Austin, TX 78751-4906

Phone

(512) 968-2591

NPI assigned

May 25, 2010

Sex

Female

Sole proprietor

Yes

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)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: clarissa.colley.1@8363.direct.athenahealth.com

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.

• Tri-County Clinical

  • Family Medicine Physician
  • Luling, TX
  • NPI 1336456227
  NPD (past)

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1487973848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 E 2ND ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787024708",
            "telephone_number": "512-968-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 AVENUE B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787514906",
            "telephone_number": "512-968-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLEY",
        "first_name": "CLARISSA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "53506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Dominic Collebrusco, MD
• Cynthia Collen, LCSW
• Karen Collett
• Christina Morgan Colletti, MD
• Lauren Johnston Colletti, FNP-C
• Cynthia Collier
• David Collier, DPT
• Ian Xavier Collier
• Jacqueline Collier
• Luke Joseph Collier, PSYD

• All providers in Austin, TX
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.