JACKIE M COLAIZY


Address: 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112
Phone: 6516289566

JACKIE M COLAIZY (NPI# 1265493167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265493167
Entity Type Individual
Full Name JACKIE M COLAIZY
Other Name JACKIE M WILM
Credential LICSW
Practice Address 1900 Silver Lake Road Nw
Suite 110
New Brighton
MN 55112
Practice Telephone 6516289566
Practice Fax Number 6516280411
Mailing Telephone 6513791718
Mailing Fax Number 6513791738
Enumeration Date 2006-03-30
Last Update Date 2016-04-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
1727 MN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN 320477400 05

Office Location

Street Address 1900 SILVER LAKE ROAD NW
SUITE 110
City NEW BRIGHTON
State MN
Zip Code 55112

Providers in the same location

NPI Name Taxonomy Address Enumeration
1265970750 Nadia Fischer-danzeisen Counselor 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2017-02-06
1417404880 Matthew Rupp Counselor 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2016-09-02
1679029748 Eric Shedd Counselor 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2016-08-29
1760935282 Katie Hermerding Marriage & Family Therapist 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2016-08-02
1093183923 Kaula Marie Ryks Counselor 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2015-09-09
1730595604 Russell Robbins Counselor 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2014-07-10
1699003111 Mary Elizabeth Becker Counselor 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2009-11-20
1740432855 Kara Renee Crain Counselor 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2008-10-21
1538250261 Chris Wallin Psychologist 1900 Silver Lake Road Nw, Suite 110, New Brighton, MN 55112 2006-09-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932729704 Owegio Wreh Technician 1405 Silver Lake Road Suite 15, New Brighton, MN 55112 2020-04-22
1205497435 Silver Lake Smiles Family Dentistry Clinic/Center 2370 Palmer Drive, New Brighton, MN 55112 2019-06-27
1932766169 Matthew Thomas Hanowski Dentist 2442 Mounds View Boulevard, Mounds View, MN 55112 2019-05-22
1437619988 Marjean Diane Leary Registered Nurse 338 New Brighton Road, Apt, Suite, Bldg. (optional), New Brighton, MN 55112 2019-03-21
1558802728 Krishna Katira Student in an Organized Health Care Education/Training Program 2442 County Hwy 10, Mounds View, MN 55112 2017-03-20
1245781608 Evan Fredrick Lieberman Counselor 1900 Silver Lake Rd, Suite 110, New Brighton, MN 55112 2016-10-20
1093262065 Ryan Zinken Nurse Practitioner 1900 Silver Lake Road, Suite 110, New Brighton, MN 55112 2016-09-07
1447703228 Alison Glodek Social Worker 2543 17th St Nw, New Brighton, MN 55112 2016-07-28
1659728194 Ge Vang Sr. Driver 2160 County Road E West #205, 2160 County Road E West #205, New Brighton, MN 55112 2016-05-14
1114373578 Jessica Gapinski Specialist/Technologist 3900 Bethel Drive, Arden Hills, MN 55112 2016-05-04
Find all providers in zip 55112

Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134146749 Sarah Jane Gross Social Worker 1900 Silver Lake Rd #110, New Brighton, MN 55112 2006-07-17
1326075813 Brian Arthur Nystrom Social Worker Brighton Professional Bldg, 1900 Silver Lake Road #110, New Brighton, MN 55112-1789 2006-06-28
1265058721 Brittney Wacek Social Worker 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 2020-06-21
1831714757 Hannah Rose Brandt Social Worker 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 2020-06-16
1801206784 Michelle Faith Social Worker 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 2014-05-01
1679901201 Anne Mclellan Social Worker 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 2013-10-16
1760724751 Ajda Lommen Social Worker 1900 Silver Lake Rd Nw, Suite 115, New Brighton, MN 55112-1786 2013-03-18
1003153792 Bethany Gavic Social Worker 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 2013-01-15
1225392764 Arielah King Social Worker 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 2012-06-29
1194081711 Suzanne Vinge Social Worker 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 2012-04-09
Find all providers in NEW BRIGHTON

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City NEW BRIGHTON
Zip Code 55112

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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