Provider Demographics
NPI:1760844229
Name:COLELLA, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:COLELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MARCIA RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-1465
Mailing Address - Country:US
Mailing Address - Phone:978-658-2238
Mailing Address - Fax:
Practice Address - Street 1:6 MARCIA RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-1465
Practice Address - Country:US
Practice Address - Phone:978-658-2238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)