Provider Demographics
NPI:1720565807
Name:COLANDREA, CAITLIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:
Last Name:COLANDREA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:COLANDREA-TUOHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:501 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2163
Mailing Address - Country:US
Mailing Address - Phone:929-333-5707
Mailing Address - Fax:
Practice Address - Street 1:149 S EUCLID AVE
Practice Address - Street 2:SUITE 4, SECOND FLOOR
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090
Practice Address - Country:US
Practice Address - Phone:929-333-5707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00592800103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent