Provider Demographics
NPI:1831457803
Name:COLON, JOSEPH (CASAC-T)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:COLON
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 39TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2909
Mailing Address - Country:US
Mailing Address - Phone:718-871-2400
Mailing Address - Fax:718-871-2431
Practice Address - Street 1:449 39TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2909
Practice Address - Country:US
Practice Address - Phone:718-871-2400
Practice Address - Fax:718-871-2431
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24246101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)