Coliberate USA

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

COLIBERATE USA

Practice address

200 W Madison St
Chicago, IL 60606-3414

Phone

(312) 210-0965

NPI assigned

Apr 19, 2024

Last updated

Apr 19, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Noel C Green, LSWNPI 1548036072

Title

Authorized Representative

Phone

(312) 818-0497

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Noel Green, LSW

  • Social Worker
  • Chicago, IL
  • NPI 1548036072
  NPD Authorized official

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1770338089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 S KEDZIE AVE # 331",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052325",
            "telephone_number": "312-210-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063414",
            "telephone_number": "312-210-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLIBERATE USA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "NOEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "312-818-0497",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendan Colgan, MD
• Jennifer Yvonne Colgan, M.D.
• Carolyn Coli
• Hannah Colias
• Lotiffa Colibao, M.D.
• Colibri Counseling
• Dragan Colic
• Laura Campbell Colicchia, M.D.
• Jessica Colin Escobar, MD
• Colin F. Ennis PSYD LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.