Colleen Marie Caldwell-McComas, LPCC
Individual provider Active NPI Professional Counselor · Fort Gay, WV
NPI 1609201342 · NPPES record last updated Jan 25, 2024
Key facts
- NPI
- 1609201342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2220 (WV)
- Practice address
- 71 Wayne St
Fort Gay, WV 25514-8518 - Phone
- (304) 648-5544
- Fax
- (304) 648-5989
- NPI assigned
- Sep 12, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240409000789 | WV | Practitioner - Mental Health Counselor | 3678911708 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103071 | KY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Health Systems Inc | Counselor | Current |
Accepting new patients |
| Valley Health Systems, Inc. | Current |
Accepting new patients | |
| Valley Health Systems Inc | Current | Accepting new patients |
Locations
71 Wayne St
Fort Gay, WV 25514
Phone (304) 648-5544
2585 3rd Ave
Huntington, WV 25703
Phone (304) 697-1396
42 McGinnis Dr
Wayne, WV 25570
Phone (304) 272-5136
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 103071 | KY | |
| Professional Counselor | 101YP2500X | 2220 | WV | Yes |
Addresses
Primary practice location
71 Wayne St
Fort Gay, WV 25514-8518
Mailing address
PO Box 1680
Huntington, WV 25717-1680
Phone (304) 697-1396
Other practice location 1
42 McGinnis Dr
Wayne, WV 25570-9553
Phone (304) 272-5136
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100266790 | Medicaid | KY | |
| 0214647 | Medicaid | OH | |
| 1609201342 | Medicaid | WV |
Other names
- Ms. Colleen Marie Caldwell
Other providers in Fort Gay, WV
- Sylva Ladawn Blackburn
- Charles Bohling
- Jeff Bowen
- Daniel Brody
- Ella Marie Brown
- Helen R Canterbury
- Billie Jo Castle
- Gabe James Castle
- Katlin Grace Christian Webb
- Coalfield Family Services, PLLC
All providers in Fort Gay, WV · Professional Counselor in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.