Active NPI
Alicia Collazo, OTR/L
- Occupational Therapist
- Brookfield, CT
National Provider Identifier
1801396080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4865
- Practice address
- 14 Lakeview Rd
Brookfield, CT 06804-1510 - Phone
- (203) 982-7138
- NPI assigned
- Feb 14, 2018
- Last updated
- Feb 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 022017 | NY | |
| Occupational Therapist | 225X00000X | 4865 | CT | Primary |
Addresses
Primary practice location
14 Lakeview Rd
Brookfield, CT 06804-1510
Mailing address
14 Lakeview Rd
Brookfield, CT 06804-1510
Phone (203) 982-7138
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022017 | NY | MD | Psychologist |
| 4865 | CT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518566400000",
"number": "1801396080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 LAKEVIEW RD",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068041510",
"telephone_number": "203-982-7138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 LAKEVIEW RD",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068041510",
"telephone_number": "203-982-7138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLAZO",
"first_name": "ALICIA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-14",
"last_updated": "2018-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "022017",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "4865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, CT
- Sue Ann Ciatto, R.D.
- Kara M Clark, PA-C
- Benjamin Burke Clippinger, M.D.
- Mark S Cohen, D.D.S.
- Rose P. Coladarci, LCSW
- Compassion Acceptance and Healing Counseling LLC
- Thomas John Condon, PH.D.
- Connecticut Breast Imaging PC
- Connecticut Center for Integrated Healthcare LLC
- Connecticut CVS Pharmacy LLC (CVS Pharmacy # 00696)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.