Provider Demographics
NPI:1770059230
Name:CALCAGNI, COLLEEN (LPC)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:
Last Name:CALCAGNI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1038
Mailing Address - Country:US
Mailing Address - Phone:888-768-4372
Mailing Address - Fax:
Practice Address - Street 1:122 W LANCASTER AVE STE 104
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-1874
Practice Address - Country:US
Practice Address - Phone:888-768-4372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010829101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional