Provider Demographics
NPI:1629520432
Name:COLASUONNO, TERESE (LPC)
Entity type:Individual
Prefix:
First Name:TERESE
Middle Name:
Last Name:COLASUONNO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:TERESE
Other - Middle Name:ELIZABETH
Other - Last Name:COLASUONNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1460 WALTON BLVD STE 50
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1729
Mailing Address - Country:US
Mailing Address - Phone:248-563-0154
Mailing Address - Fax:866-745-6418
Practice Address - Street 1:1460 WALTON BLVD STE 50
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1729
Practice Address - Country:US
Practice Address - Phone:248-563-0154
Practice Address - Fax:866-745-6418
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional