Provider Demographics
NPI:1467732628
Name:ABENDROTH, COLLEEN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:ELIZABETH
Last Name:ABENDROTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:COLLEEN
Other - Middle Name:ELIZABETH
Other - Last Name:PISONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4326 LINDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2702
Mailing Address - Country:US
Mailing Address - Phone:314-533-2229
Mailing Address - Fax:314-533-3098
Practice Address - Street 1:4326 LINDELL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2702
Practice Address - Country:US
Practice Address - Phone:314-533-2229
Practice Address - Fax:314-533-3098
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker