Individual provider Active NPI

Stephen Andrew Collazo, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1679080212
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
51887 Issued in TX
Practice address
3910 McDuffie St Apt 14
Houston, TX 77098-2530
Phone
(409) 749-4588
NPI assigned
Jan 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 51887 TX Primary

Addresses

Primary practice location

3910 McDuffie St Apt 14
Houston, TX 77098-2530

Mailing address

3910 McDuffie St Apt 14
Houston, TX 77098-2530
Phone (409) 749-4588

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

LicenseStateTypeSpecialty
51887TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1679080212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 MCDUFFIE ST APT 14",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770982530",
            "telephone_number": "409-749-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 MCDUFFIE ST APT 14",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770982530",
            "telephone_number": "409-749-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "STEPHEN",
        "middle_name": "ANDREW",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "51887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.