Marylyn Dunlap Colburn, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106297 Issued in MA

Practice address

1132 Westfield St
West Springfield, MA 01089-3878

Phone

(413) 592-1980

Fax

(413) 439-0096

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marylyn Dunlap Lowrey Former name

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthdrive Behavioral Health Services, PLLCGroup PAC ID 8729345822, 89 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Healthdrive Behavioral Health Services, PLLC

  • Geriatric Psychiatry Physician
  • Middletown, CT
  • NPI 1760909279

  Clinical, MA

  Medicare reassignment Care Compare group NPD
• Massbay Counseling,Inc.

  • Clinical Social Worker
  • Marshfield, MA
  • NPI 1750437604
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1497761266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 OLD DERBY ST",
            "address_2": "SUITE 451",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020434005",
            "telephone_number": "617-688-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 WESTFIELD ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893878",
            "telephone_number": "413-592-1980",
            "fax_number": "413-439-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "MARYLYN",
        "middle_name": "DUNLAP",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00418015",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYLYN",
            "last_name": "LOWREY",
            "middle_name": "DUNLAP",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allison Cohen, LICSW
• Jaime A. Cohen, D.O.
• Katie Cohen, LCSW
• Yael Tepperberg Cohn, LICSW
• Nicole Coite
• Cole G. Archambault DMD, PLLC
• Brigette Lynn Cole, MD
• Miranda Cole
• Nadine Armelle Collier, NP-C
• Kelsey L Collis

• Clinical Social Worker in West Springfield, MA
• Providers in West Springfield, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.