Active NPI
Colleen Mae McKinnon, LCSW
- Clinical Social Worker
- Nevada City, CA
National Provider Identifier
1548439987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS11935
- Practice address
- 230 Main St
Suite 2C
Nevada City, CA 95959-2509 - Phone
- (530) 274-1469
- NPI assigned
- Feb 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS11935 | CA | Primary |
Addresses
Primary practice location
230 Main St
Suite 2C
Nevada City, CA 95959-2509
Mailing address
PO Box 2064
Nevada City, CA 95959-1942
Phone (530) 274-1469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160317002386 | CA | Practitioner - Clinical Social Worker | 5799082707 | Practice locations: Nevada City, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
419 Spring St
Suite C
Nevada City, CA 95959-2446
Phone (530) 955-5697
PO Box
Suite 2064
Nevada City, CA 95959-1942
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS11935 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1548439987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2064",
"city": "NEVADA CITY",
"state": "CA",
"postal_code": "959591942",
"telephone_number": "530-274-1469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 MAIN ST",
"address_2": "SUITE 2C",
"city": "NEVADA CITY",
"state": "CA",
"postal_code": "959592509",
"telephone_number": "530-274-1469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNON",
"first_name": "COLLEEN",
"middle_name": "MAE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-28",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS11935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nevada City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.