Provider Demographics
NPI:1275680886
Name:WELLINGTON, COLETTE A (MA)
Entity Type:Individual
Prefix:MRS
First Name:COLETTE
Middle Name:A
Last Name:WELLINGTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:COCO
Other - Middle Name:A
Other - Last Name:WELLINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:57 RANGELEY RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3017
Mailing Address - Country:US
Mailing Address - Phone:617-232-7307
Mailing Address - Fax:
Practice Address - Street 1:27 HOLLIS ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8615
Practice Address - Country:US
Practice Address - Phone:508-935-0760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA149101YA0400X
MA1245101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health