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NPI Code Detail

MEDICARE: MS. REBECCA COLTIN LICSW

MEDICARE: MS. REBECCA COLTIN LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2104100000XSocial Worker

General Provider Information

NPI Number : 1043642325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. REBECCA COLTIN LICSW
Provider Business Mailing Address
First Line : 611 WATERTOWN ST APT 11
Second Line :
City : NEWTON
State : MA
Zip : 02460-1327
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 115 MILL ST
Second Line :
City : BELMONT
State : MA
Zip : 02478-1048
Country : US
Telephone Number : 508-380-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2013
Last Update Date : 01/13/2020

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Directions to “ MS. REBECCA COLTIN LICSW” Practice Location

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