Provider Demographics
NPI:1255628152
Name:IGNATOWSKI, COLLEEN (LCAT)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:IGNATOWSKI
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 BLOSSOM RD STE 301A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1870
Mailing Address - Country:US
Mailing Address - Phone:585-406-7794
Mailing Address - Fax:
Practice Address - Street 1:595 BLOSSOM RD STE 301A
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1870
Practice Address - Country:US
Practice Address - Phone:585-406-7794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NY002018-01101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor