Healthcare Provider Details

I. General information

NPI: 1750298618
Provider Name (Legal Business Name): JENNIFER MARGARET COLELLO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 E PARHAM RD STE 102
HENRICO VA
23294-4366
US

IV. Provider business mailing address

2331 YORK RD STE 100
TIMONIUM MD
21093-2246
US

V. Phone/Fax

Practice location:
  • Phone: 667-668-2566
  • Fax:
Mailing address:
  • Phone: 667-668-2566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0024197630
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: