Colten Dean Coffin, MA, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149021134 Issued in IL

Practice address

12145 Western Ave
Blue Island, IL 60406-1387

Phone

(773) 537-3992

NPI assigned

Nov 6, 2017

Last updated

Apr 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifepath Therapy Associates, LLCGroup PAC ID 7911333703, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Lifepath Therapy Associates, LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1629636394
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1891208419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 W ARGYLE ST # 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403610",
            "telephone_number": "312-213-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12145 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604061387",
            "telephone_number": "773-537-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFIN",
        "first_name": "COLTEN",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "MA, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-06",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150102660",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149021134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Elizabeth Churchey-Mims, MA
• Aubrey Lynn Ciesiun
• City of Blue Island (Blue Island Fire Department)
• Catherine Clark, SLP
• Julisa Clark
• Arlease Coleman, C.F.P.P.
• Melissa Coleman
• Randi Coley, CADC
• Jeanine Connolly, MD
• Cook County (Cook County Health at Blue Island Health Center)

• Clinical Social Worker in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.