Colleen Jillson, LCSW, LADC, CCS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC17006 Issued in ME

Practice address

86 Tandberg TRL
Windham, ME 04062-5841

Phone

(207) 893-0386

NPI assigned

Mar 7, 2012

Last updated

Mar 20, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Colleen Jillson Counseling Services LLC

  • Community/Behavioral Health Agency
  • Lewiston, ME
  • NPI 1780331520
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1851665939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1360",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040621360",
            "telephone_number": "207-893-0386",
            "fax_number": "207-893-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 TANDBERG TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625841",
            "telephone_number": "207-893-0386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Main St",
            "address_purpose": "LOCATION",
            "city": "Biddeford",
            "state": "ME",
            "postal_code": "040052410",
            "country_code": "US",
            "telephone_number": "207-893-0386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JILLSON",
        "first_name": "COLLEEN",
        "credential": "LCSW, LADC, CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC4982",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "E400450569",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851665939",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael James Jackson, RNFA
• Warren Jackson, OD
• Patricia Jacobsen Kaczmarek, LMT
• Jeffrey E Martin MD
• Ashly D Jewell, FNP
• Kayley Ann Johnson
• Paul J Johnson, PHARM D
• Journey Therapeutic Solutions LLC
• Juan Mateo Pmhnp-BC PLLC
• Kwonduk Jung, DMD

• Clinical Social Worker in Windham, ME
• Providers in Windham, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.