Michael Colleran, MT-BC

Primary specialty

Music TherapistTaxonomy code 225A00000X

License

16213

Practice address

3151 Stony St
Mohegan Lake, NY 10547-1913

Phone

(914) 885-1995

NPI assigned

Jan 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1992466429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 STONY ST",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 STONY ST",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471913",
            "telephone_number": "914-885-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLERAN",
        "first_name": "MICHAEL",
        "credential": "MT-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": null,
            "license": "16213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION BOARD OF MUSIC THERAPISTS ID #",
            "identifier": "16213",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcolleran@shruboak.com",
            "affiliation": "N",
            "endpointDescription": "Encrypted email system",
            "address_1": "3151 Stony St",
            "city": "Mohegan Lake",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105471913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Lee Berndt, LPN
• George Jake Canal, OCCUP. THERAPIST
• Brenda Chan, OD
• Amy Chang, MA, CCC-SLP, TSHH
• John Christ
• Jose Luis Colon, M.S.,R.PH.
• Jessica C Courtien, OTA
• Bernadette Ann Coyne, MA CCC/SLP
• Lydia Cuevo, R.N.
• Lynn Ann Culbertson, PT, DPT

• All providers in Mohegan Lake, NY
• Music Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.