Active NPI
Colleen Bohlander Kradel, LICSW
- Clinical Social Worker
- Martinsburg, WV
National Provider Identifier
1740414473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- DP02943349
- Practice address
- 316 W Stephen St
Martinsburg, WV 25401-3242 - Phone
- (540) 532-0220
- NPI assigned
- May 9, 2009
- 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 | DP02943349 | WV | Primary |
Addresses
Primary practice location
316 W Stephen St
Martinsburg, WV 25401-3242
Mailing address
375 Symington Dr
Martinsburg, WV 25404-7268
Phone (540) 532-0220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 15, 2025 through Apr 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DP02943349 | WV | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241827200000",
"number": "1740414473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 SYMINGTON DR",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254047268",
"telephone_number": "540-532-0220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 W STEPHEN ST",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254013242",
"telephone_number": "540-532-0220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRADEL",
"first_name": "COLLEEN",
"middle_name": "BOHLANDER",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-09",
"last_updated": "2009-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WV",
"license": "DP02943349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.