Provider Demographics
NPI:1003425059
Name:COLASANTI, ADRINA MARIE (BA)
Entity Type:Individual
Prefix:
First Name:ADRINA
Middle Name:MARIE
Last Name:COLASANTI
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 SHAYLA CT
Mailing Address - Street 2:
Mailing Address - City:RINEYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40162-9418
Mailing Address - Country:US
Mailing Address - Phone:270-360-1662
Mailing Address - Fax:
Practice Address - Street 1:113 SHAYLA CT
Practice Address - Street 2:
Practice Address - City:RINEYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40162-9418
Practice Address - Country:US
Practice Address - Phone:270-360-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker