Provider Demographics
NPI:1013436203
Name:COLLEBRUSCO, AUNDREA L (LCSW)
Entity type:Individual
Prefix:
First Name:AUNDREA
Middle Name:L
Last Name:COLLEBRUSCO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E CHESTNUT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2582
Mailing Address - Country:US
Mailing Address - Phone:828-552-3771
Mailing Address - Fax:828-319-2812
Practice Address - Street 1:225 E CHESTNUT ST STE 100
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2582
Practice Address - Country:US
Practice Address - Phone:828-552-3771
Practice Address - Fax:828-319-2812
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0127641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical