Individual provider Active NPI

Jill Elizabeth McCollough, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1922974930
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34012320A Issued in IN
Practice address
5470 E 16TH St
Indianapolis, IN 46218-4861
Phone
(317) 355-5394
Fax
(317) 351-7850
NPI assigned
Oct 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 34012320A IN Primary

Addresses

Primary practice location

5470 E 16TH St
Indianapolis, IN 46218-4861

Mailing address

12093 Seahawks LN
Fishers, IN 46037-9699
Phone (765) 744-9929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20251027003187 IN Practitioner - Clinical Social Worker 5698264075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Network IncGroup PAC ID 1850203977, 95 clinicians

Practice addresses (Care Compare)

5470 E 16TH St
Gallahue Mental Health Services
Indianapolis, IN 46218-4861
Phone (317) 355-5394

6950 Hillsdale CT
Indianapolis, IN 46250-2040
Phone (317) 621-7740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34012320AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Network, Inc Single Specialty Current Accepting new patients
Community Health Network, Inc CurrentSince Oct 21, 2025 Accepting new patients
Community Health Network, Inc. Past Accepting new patients

Locations

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

5470 E 16th St
Indianapolis, IN 46218
Phone (317) 355-5009

Organizations & group practices 3

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": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1922974930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12093 SEAHAWKS LN",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379699",
            "telephone_number": "765-744-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5470 E 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184861",
            "telephone_number": "317-355-5394",
            "fax_number": "317-351-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLOUGH",
        "first_name": "JILL",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34012320A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.