Charles Colclough, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078542 Issued in NY

Practice address

25 E 183Rd St
Bronx, NY 10453-1242

Phone

(718) 483-1270

Fax

(718) 228-7471

NPI assigned

May 22, 2007

Sex

Male

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

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.

• Bridges Counseling and Psychotherapy Group

  • Mental Health Counselor
  • Fishkill, NY
  • NPI 1144434226
  Medicare reassignment NPD
• Morris Heights Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1184694291
  Medicare reassignment NPD
• Morris Heights Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1104374685
  NPD

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1740490796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534015",
            "telephone_number": "718-483-1270",
            "fax_number": "718-228-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E 183RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531242",
            "telephone_number": "718-483-1270",
            "fax_number": "718-228-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLCLOUGH",
        "first_name": "CHARLES",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Sabrina Colahar, M.D.
• Francius Colas
• Mary Lynn Colavita, M.D.
• Paris Colbert
• Alexis Colby, LMSW
• Jacqueline Colclough
• Wilhelmina Duque Colcol, PHARMACIST
• Maxine E Cole -Wiltshire, LMSW
• Cole Vision Corporation
• Adam Cole, M.D.

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, 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 Mar 30, 2012; 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.