Irene Monica Collazo, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC60419650 Issued in WA

Practice address

700 NE 87TH Ave Ste 220
Vancouver, WA 98664-4896

Phone

(360) 882-2778

Fax

(360) 604-1767

NPI assigned

Feb 11, 2019

Last updated

Feb 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tara May, PHD, PLLC

  dba Blue Leaf Counseling

  • Adult Mental Health Clinic/Center
  • Vancouver, WA
  • NPI 1558873729
  NPD (past)

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1659837052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE STE 220",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "IRENE",
        "middle_name": "MONICA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60419650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin Colegrove, D.O.
• Janet Lynn Coleman, R.PH.
• Matthew Aaron Coleman, DO
• Ryan Colin
• Leslie Ann Colip, M.D.
• Barbara Jean Colleran, RN
• Kris Colletto, M.D.
• Joshua D Colley, PA-C
• Andrea Collier, LMP
• Savannah Collier, MD

• Clinical Social Worker in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.