Provider Demographics
NPI:1912682691
Name:COLLEEN PASSETTO - LICSW
Entity Type:Organization
Organization Name:COLLEEN PASSETTO - LICSW
Other - Org Name:COLLEEN PASSETTO - LICSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, LICSW
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PASSETTO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:413-655-1161
Mailing Address - Street 1:PO BOX 1249
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01235-1249
Mailing Address - Country:US
Mailing Address - Phone:413-655-1161
Mailing Address - Fax:413-251-0551
Practice Address - Street 1:250 NEW WINDSOR RD
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:MA
Practice Address - Zip Code:01235-9362
Practice Address - Country:US
Practice Address - Phone:413-655-1161
Practice Address - Fax:413-251-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty