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General NPI Number Information
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NPI Number | 1164768297
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Entity Type | Organization
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Legal Business Name | COLONIE COUNSELING SERVICES, LCSW, PLLC
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | 1707 CENTRAL AVE
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City | ALBANY
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State | NY
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Zip | 12205
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Country | US
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Telephone | 518-464-0232
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Fax | 518-464-0202
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Provider Business Mailing Address
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Address Line | 1707 CENTRAL AVE.
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City | ALBANY
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State | NY
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Zip | 12205
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Country | US
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Telephone | 518-464-0232
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Fax | 518-464-0202
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Authorized Official
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Title or Position | OWNER
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Name | SHARON R. POLOVINA
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Credential | LCSW
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Telephone | 518-464-0232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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