Active NPI
Elizabeth S McColl, LCSW
- Clinical Social Worker
- Knoxville, TN
National Provider Identifier
1699875104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 260
- Practice address
- 4619 Chambliss Ave
Knoxville, TN 37919-5119 - Phone
- (865) 659-6631
- Fax
- (865) 558-3495
- NPI assigned
- Sep 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 260 | TN | Primary |
Addresses
Primary practice location
4619 Chambliss Ave
Knoxville, TN 37919-5119
Mailing address
4619 Chambliss Ave
Knoxville, TN 37919-5119
Phone (865) 659-6631
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0103968 | Other | TN | BCBS |
| 3989856 | Medicaid | TN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 260 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699875104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4619 CHAMBLISS AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379195119",
"telephone_number": "865-659-6631",
"fax_number": "865-558-3495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4619 CHAMBLISS AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379195119",
"telephone_number": "865-659-6631",
"fax_number": "865-558-3495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOLL",
"first_name": "ELIZABETH",
"middle_name": "S",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0103968",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3989856",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.