Healthcare Provider Details

I. General information

NPI: 1922153485
Provider Name (Legal Business Name): BARBARA COLWELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA CHECCHIA

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 COURT ST
BINGHAMTON NY
13901-3515
US

IV. Provider business mailing address

184 COURT ST
BINGHAMTON NY
13901-3515
US

V. Phone/Fax

Practice location:
  • Phone: 607-584-4465
  • Fax: 607-584-4480
Mailing address:
  • Phone: 607-584-4465
  • Fax: 607-584-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR052673-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: