Healthcare Provider Details

I. General information

NPI: 1780500298
Provider Name (Legal Business Name): EDELMARIS COLINDRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 HILLSIDE AVE PMB 162
HARRISOBURG VA
22801
US

IV. Provider business mailing address

1322 HILLSIDE AVE PMB 162
HARRISOBURG VA
22801
US

V. Phone/Fax

Practice location:
  • Phone: 540-606-2240
  • Fax:
Mailing address:
  • Phone: 540-606-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020099
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: