Healthcare Provider Details

I. General information

NPI: 1932401718
Provider Name (Legal Business Name): ROSE P. COLADARCI LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 FEDERAL RD SUITE C23-A
BROOKFIELD CT
06804-2647
US

IV. Provider business mailing address

1 5TH ST
DANBURY CT
06810-5703
US

V. Phone/Fax

Practice location:
  • Phone: 203-744-8399
  • Fax: 203-744-8399
Mailing address:
  • Phone: 203-744-8399
  • Fax: 203-744-8399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004585
License Number StateCT

VIII. Authorized Official

Name: ROSE P. COLADARCI
Title or Position: MANAGING MEMBER
Credential: LCSW
Phone: 203-744-8399