Active NPI
Colleen Prokop
- Social Worker
- Woodmere, OH
National Provider Identifier
1558085522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2309662
- Practice address
- 27600 Chagrin Blvd
Woodmere, OH 44122-4439 - Phone
- (216) 417-8813
- NPI assigned
- Oct 3, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2309662 | OH | Primary |
Addresses
Primary practice location
27600 Chagrin Blvd
Woodmere, OH 44122-4439
Mailing address
26911 Elizabeth LN
Olmsted TWP, OH 44138-1152
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2309662 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1558085522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26911 ELIZABETH LN",
"city": "OLMSTED TWP",
"state": "OH",
"postal_code": "441381152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27600 CHAGRIN BLVD",
"city": "WOODMERE",
"state": "OH",
"postal_code": "441224439",
"telephone_number": "216-417-8813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROKOP",
"first_name": "COLLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-03",
"last_updated": "2023-07-27",
"certification_date": "2023-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2309662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodmere, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.