CMS-1500 Box 24J / 33a • NPI
1659186708
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
104100000X
Licensed & Credentialed Social Worker
Box 32 Service Location & ZIP+4
205 5TH AVE S STE 508, LA CROSSE, WI, 54601-4059
✓ 9-Digit EDI 837 ZIP+4 (54601-4059)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1659186708 (COLYN BERG, MSW, APSW, SAC-IT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1659186708 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | COLYN BERG, MSW, APSW, SAC-IT |
| Plain-English Specialty | Licensed & Credentialed Social Worker NUCC Code: 104100000X (Social Worker) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 205 5TH AVE S STE 508, LA CROSSE, WI, 54601-4059 |
| Practice Telephone / Fax | Tel: (608) 387-9638 |
| Administrative Mailing Address | 505 E OLSON ST, BLAIR, WI, 54616-9307 |
| Enumeration & Last Sync | Enumerated: 2025-02-07 | CMS Record Updated: 2025-02-07 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (104100000X)
What Does Taxonomy Code 104100000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 104100000X translates to:
"Licensed & Credentialed Social Worker"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (COLYN BERG, MSW, APSW, SAC-IT)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101YA0400X — Counselor, Addiction (Substance Use Disorder)Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) | State: WI | License: 20459-130 | Primary: Secondary |
104100000X — Social WorkerPlain English: Licensed & Credentialed Social Worker | State: MI | License: 6851119332 | Primary: Secondary |
405300000X — Prevention ProfessionalPlain English: Licensed & Credentialed Prevention Professional | State: WI | License: 17013-137 | Primary: Secondary |
104100000X — Social WorkerPlain English: Licensed & Credentialed Social Worker | State: WI | License: 135215-121 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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