Colette Marcellus, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084937 Issued in NY

Practice address

100 Washington St
Elmira, NY 14901-2849

Phone

(607) 737-4800

NPI assigned

Apr 18, 2017

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Elmira Psychiatric Center Community Clinic

  • Clinic/Center
  • Elmira, NY
  • NPI 1497401624
  NPD

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1700310620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153",
            "city": "ULSTER",
            "state": "PA",
            "postal_code": "188500153",
            "telephone_number": "607-737-4966",
            "fax_number": "607-737-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASHINGTON ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149012849",
            "telephone_number": "607-737-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLUS",
        "first_name": "COLETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven A. Manierre, RPA-C
• Gary Neil Mann, MD
• Nan Mansfield, R.D.
• Kenneth Edward Mantei, RPH
• Joseph P Manzullo, RPH
• Erin Marean
• Antoinette Maria, NP
• Joseph John Marino, DC
• Mark G. Schuller D.D.S.,P.C.
• Marriage and Family Therapy Services of the Southern Tier, P.C.

• Clinical Social Worker in Elmira, NY
• Providers in Elmira, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.