Provider Demographics
NPI:1316403785
Name:LUCIANNE E COLLADO, LLC
Entity Type:Organization
Organization Name:LUCIANNE E COLLADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCIANNE
Authorized Official - Middle Name:ELIETTE
Authorized Official - Last Name:COLLADO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-397-2185
Mailing Address - Street 1:52 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2024
Mailing Address - Country:US
Mailing Address - Phone:978-397-2185
Mailing Address - Fax:
Practice Address - Street 1:57 GREEN ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-5803
Practice Address - Country:US
Practice Address - Phone:978-397-2185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty