Active NPI
Andrea M Coleman, LICSW
- Clinical Social Worker
- South Hadley, MA
National Provider Identifier
1861520041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 111194
- Practice address
- 27 College St
South Hadley, MA 01075-6461 - Phone
- (413) 253-9474
- NPI assigned
- Mar 1, 2007
- 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 | 111194 | MA | Primary |
Addresses
Primary practice location
27 College St
South Hadley, MA 01075-6461
Mailing address
15 Woodside Ave
Amherst, MA 01002-2524
Phone (413) 256-8050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P08499 | Other | MA | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 3, 2024 through Oct 3, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861520041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 WOODSIDE AVE",
"city": "AMHERST",
"state": "MA",
"postal_code": "010022524",
"telephone_number": "413-256-8050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 COLLEGE ST",
"city": "SOUTH HADLEY",
"state": "MA",
"postal_code": "010756461",
"telephone_number": "413-253-9474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "ANDREA",
"middle_name": "M",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "111194",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "P08499",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Hadley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.