Active NPI
Colleen McLoughlin
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1801617204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 116903
- Practice address
- 2725 Congress St Ste 1D
San Diego, CA 92110-2766 - Phone
- (619) 288-6866
- NPI assigned
- Oct 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 116903 | CA | Primary |
Addresses
Primary practice location
2725 Congress St Ste 1D
San Diego, CA 92110-2766
Mailing address
2725 Congress St Ste 1D
San Diego, CA 92110-2766
Phone (619) 288-6866
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116903 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute of Modern Recovery | Clinical | Current | Accepting new patients |
Locations
2725 Congress St
Ste 1D
San Diego, CA 92110
Phone (619) 288-6866
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729209600000",
"number": "1801617204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 CONGRESS ST STE 1D",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921102766",
"telephone_number": "619-288-6866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 CONGRESS ST STE 1D",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921102766",
"telephone_number": "619-288-6866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLOUGHLIN",
"first_name": "COLLEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-18",
"last_updated": "2024-10-18",
"certification_date": "2024-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "116903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.