Healthcare Provider Details

I. General information

NPI: 1851522999
Provider Name (Legal Business Name): LAURA COLON FELICIANO LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA BERTINI-COLON LCSW, LMSW

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 05/04/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KEANE ELEMENTARY SCHOOL ANNEX, CRISIS PREVENTION TEAM 1252 ALBANY ST.
SCHENECTADY NY
12304-2702
US

IV. Provider business mailing address

245 BRADFORD RD
SCHENECTADY NY
12304-3704
US

V. Phone/Fax

Practice location:
  • Phone: 518-952-1283
  • Fax:
Mailing address:
  • Phone: 518-925-6781
  • Fax: 518-346-6820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number079739
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number083510
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: