Provider Demographics
NPI:1497039804
Name:COLANDO, ADAM CHARLES (MS,LMHC, CAP)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:CHARLES
Last Name:COLANDO
Suffix:
Gender:M
Credentials:MS,LMHC, CAP
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 463
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:FL
Mailing Address - Zip Code:32702-0463
Mailing Address - Country:US
Mailing Address - Phone:352-636-8178
Mailing Address - Fax:
Practice Address - Street 1:533 N NOVA RD
Practice Address - Street 2:#204
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4447
Practice Address - Country:US
Practice Address - Phone:352-636-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11652101YM0800X
FLCAP5916101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)