Eric Edward McCollum, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904002459 Issued in VA

Practice address

1984 Isaac Newton SQ W
Suite 204
Reston, VA 20190-5038

Phone

(703) 899-1097

NPI assigned

Jan 13, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473033600000",
    "number": "1538499595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3936 TALLOW TREE PL",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332467",
            "telephone_number": "703-803-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1984 ISAAC NEWTON SQ W",
            "address_2": "SUITE 204",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905038",
            "telephone_number": "703-899-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "ERIC",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-13",
        "last_updated": "2016-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002459",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Behrang T Mazahery, MD
• Catherine Mbony
• Allison Neal McArthur, PT
• Herbert A McCall, RPH
• Megan E McClelland, RD
• Irma R McDonald, CRNA
• Katherine Jeanne McDonald
• Ashley McDougald, LCSW
• Bridget Ann McFalls
• Hugh William McGee Jr., PT

• Clinical Social Worker in Reston, VA
• Providers in Reston, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2016; 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.