TELLISSA A COLGLAZIER LCSW
NPI 1174143119
Social Worker - Clinical in Portland, IN

Q: What is Tellissa Colglazier's NPI number?

The NPI number for Tellissa Colglazier is 1174143119. It was assigned to this individual provider in the NPPES registry on April 20, 2020.

Q: What is Tellissa Colglazier's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since April 20, 2020PECOS EnrolledAccepts Medicare Assignment

1758 W 100 S, PORTLAND, IN 47371(260) 726-1960(260) 726-1980 Get Directions Write a Review

NPPES record last updated: November 8, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Nov 8, 2023, Apr 20, 2020 (2 updates tracked since 2020).

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About Tellissa A Colglazier Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TELLISSA A COLGLAZIER LCSW (NPI 1174143119) is an individual clinical provider in Portland, Indiana, licensed in Indiana (34010693A) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, is affiliated with Indiana University Health Jay, Inc., and maintains a secondary practice location in Muncie.

NPPES Registry Identity

NPI1174143119

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameTELLISSA A COLGLAZIERCredential: LCSW

Location Address1758 W 100 SPortland, IN 47371-8204

Mailing Address250 N Shadeland AveIndianapolis, IN 46219-4959

Phone(260) 726-1960

Fax(260) 726-1980

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateApril 20, 2020

Last NPPES UpdateNovember 8, 20232 updates tracked since enumeration

NPPES CertifiedNovember 8, 2023

✔ NPI 1174143119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in IN · 34010693A

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.

Also ListedCounselorTaxonomy 101Y00000X

1758 W 100 S, Portland, IN 47371

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Secondary Practice Location 1

Location 1240 N Tillotson AveMuncie, IN 47304-3988 · Phone (765) 288-1928 · Fax (765) 741-0359

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tellissa A Colglazier Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113374349

PECOS Enrollment IDI20231109002881

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Indiana University Health Jay, Inc.

Critical Access Hospitals · Portland, IN

OwnershipGovernment - Local

CMS Certification Number151320

Location500 W Votaw StPortland, IN 47371 · Jay County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47371 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $53.07 – $161.76

Typical copayment $0.00 (range $13.26 – $40.44)

Most-billed visit code NA

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VORMOHR MEDICAL CENTER

Family Medicine