Kerrie Collazo

Primary specialty

Social WorkerTaxonomy code 104100000X

License

107633 Issued in NY

Practice address

191 Dorchester Rd
Garden City, NY 11530-5610

Phone

(516) 850-2795

NPI assigned

Oct 29, 2019

Sex

Female

Sole proprietor

Yes

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

Specialty

Clinical Social Worker

Education

State University of New York at Stony Brook, School of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Positive Pathway LCSW Psychotherapy PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Garden City, NY
  • NPI 1568292506
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1780228106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 DORCHESTER RD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305610",
            "telephone_number": "516-850-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 DORCHESTER RD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305610",
            "telephone_number": "516-850-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "KERRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "107633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy Marc Cohn, M.D.
• Adriana Coico, PA
• Michael Colantuono
• Jennifer G Colbert, LCSW
• Hannah J Colelli, LMSW
• Christina Collichio, MA
• Casey-Ann Cristal Collins, FNP
• Dana Colombini
• Colon & Rectal Associates of Nassau, PLLC
• Colon & Rectal Surgical Practice of Nassau, PLLC

• Social Worker in Garden City, NY
• Providers in Garden City, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.