Provider Demographics
NPI:1225348543
Name:COLON, MADELINE
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:147 MUZZY ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-3416
Mailing Address - Country:US
Mailing Address - Phone:413-540-1194
Mailing Address - Fax:
Practice Address - Street 1:120 MAPLE STREET
Practice Address - Street 2:CARSON CENTER FOR HUMAN SERVICES
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103
Practice Address - Country:US
Practice Address - Phone:413-737-3730
Practice Address - Fax:413-572-4117
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health