John Laurence Kolodin, MSW LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1018332 Issued in MA

Practice address

110 North Hillside Road
Suite 26
South Deerfield, MA 01373

Phone

(413) 665-4158

NPI assigned

Jan 17, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750433850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 NORTH HILLSIDE ROAD",
            "address_2": "SUITE 26",
            "city": "SOUTH DEERFIELD",
            "state": "MA",
            "postal_code": "01373",
            "telephone_number": "413-665-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NORTH HILLSIDE ROAD",
            "address_2": "SUITE 26",
            "city": "SOUTH DEERFIELD",
            "state": "MA",
            "postal_code": "01373",
            "telephone_number": "413-665-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODIN",
        "first_name": "JOHN",
        "middle_name": "LAURENCE",
        "name_prefix": "Mr.",
        "credential": "MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1018332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1852353",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Hoffman
• Jacqueline M Humphreys, LICSW
• Jen Malcolm-Brown, PLLC
• Justine Karanian, D.M.D.
• Jessica King, LMHC
• Alice Kraiza
• Barbara E. Krolick, RD, LDN
• Margaret Walden Krone, PHD
• Seth B Kupferschmid, M.D.
• Robert R. Leitch, MD

• Clinical Social Worker in South Deerfield, MA
• Providers in South Deerfield, MA by specialty
• Clinical Social Worker in Massachusetts

• 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.

Verify at the official NPI Registry.