Active NPI
Colleen Whelan
- Mental Health Occupational Therapist
- Columbia, MD
National Provider Identifier
1679334544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Occupational Therapist
- License
- 30514
- Practice address
- 8805 Columbia 100 Pkwy Ste 105&106
Columbia, MD 21045-2201 - Phone
- (410) 639-5245
- NPI assigned
- Jan 18, 2024
- 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 |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | 30514 | MD | Primary |
Addresses
Primary practice location
8805 Columbia 100 Pkwy Ste 105&106
Columbia, MD 21045-2201
Mailing address
5150 Downwest Ride
Columbia, MD 21044-1506
Phone (240) 314-9492
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 |
|---|---|---|---|
| 30514 | MD | MD | Mental Health Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1679334544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5150 DOWNWEST RIDE",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210441506",
"telephone_number": "240-314-9492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8805 COLUMBIA 100 PKWY STE 105&106",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210452201",
"telephone_number": "410-639-5245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHELAN",
"first_name": "COLLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-18",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": "MD",
"license": "30514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.