Active NPI
Cassandra Cecila Colombo-Hickson
- Social Worker
- Phoenix, AZ
National Provider Identifier
1891399226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 10941283
- Practice address
- 4124 W Beryl Ave
Phoenix, AZ 85051-1030 - Phone
- (623) 261-7334
- NPI assigned
- Nov 25, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 10941283 | AZ | Primary |
Addresses
Primary practice location
4124 W Beryl Ave
Phoenix, AZ 85051-1030
Mailing address
PO Box 16906
Phoenix, AZ 85011-6906
Phone (602) 279-1427
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 |
|---|---|---|---|
| 10941283 | AZ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1891399226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16906",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850116906",
"telephone_number": "602-279-1427",
"fax_number": "602-279-1431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4124 W BERYL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850511030",
"telephone_number": "623-261-7334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLOMBO-HICKSON",
"first_name": "CASSANDRA",
"middle_name": "CECILA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-25",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "10941283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.