Tellissa A. Colglazier, LCSW
NPI 1174143119ActiveIndividual· Social Worker, Clinical· Portland, IN
Social Worker, Clinical (LCSW) with Iu Health Medical Group LLC and 2 other groups, practicing in Portland, Indiana. Enrolled in Medicare as practitioner - clinical social worker. Lists Indiana University Health Jay, Inc. as a hospital affiliation.
Overview
| NPI | 1174143119 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | No |
| NPI issued | Apr 20, 2020 |
| Last updated in NPPES | Nov 8, 2023 |
| Certified by provider | Nov 8, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 34010693A | IN |
| Counselor | 101Y00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (IN) |
|---|
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical groups
- Iu Health Medical Group LLCIndianapolis, IN · 4,462 clinicians
- Mental Health Specialty Group PALake Worth, FL · 801 clinicians
- Indiana University Health Ball Memorial Physicians IncMuncie, IN · 232 clinicians
Hospital affiliation
- Indiana University Health Jay, Inc.Portland, IN
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