Colleen Marie Coakley, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0030248 Issued in OH

Practice address

12630 Mayfield Rd
Cleveland Heights, OH 44106-6203

Phone

(216) 287-7480

NPI assigned

Mar 4, 2012

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

Enrolled in OH

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

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1330819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1538433826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 MAYFIELD RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441066203",
            "telephone_number": "216-287-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 MAYFIELD RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441066203",
            "telephone_number": "216-287-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAKLEY",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-04",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0030248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Cleveland Heights, OH
• Providers in Cleveland Heights, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.