Provider Demographics
NPI:1376099580
Name:HONSOWETZ, COLLETTE
Entity Type:Individual
Prefix:
First Name:COLLETTE
Middle Name:
Last Name:HONSOWETZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:WV
Mailing Address - Zip Code:26032-0017
Mailing Address - Country:US
Mailing Address - Phone:304-250-9377
Mailing Address - Fax:
Practice Address - Street 1:1600 NATIONAL RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5567
Practice Address - Country:US
Practice Address - Phone:304-250-9377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2209101Y00000X, 101YM0800X
PA008639101Y00000X
OH1600094101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor