MEDICARE: CARLA COLELLO LCSW

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
1	1041C0700X	Clinical Social Worker	CW-012138	PA

General Provider Information

NPI Number	:	1194188235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA COLELLO LCSW

Provider Business Mailing Address
First Line	:	832 STONEBRIDGE DR
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-5861
Country	:	US
Telephone Number	:	724-853-1843
Fax Number	:

Provider Business Practice Location Address
First Line	:	1809 SIDNEY ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1717
Country	:	US
Telephone Number	:	412-381-9141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2016
Last Update Date	:	04/04/2016

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Directions to “ CARLA COLELLO LCSW” Practice Location

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