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General NPI Number Information
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NPI Number | 1881598902
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Entity Type | Organization
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Legal Business Name | COLLEY SOCIAL WORK SERVICES, LLC
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Dates
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Enumeration Date | 10/03/2026
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Last Update Date | 10/03/2026
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Provider Practice Location Address
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Address Line | 13017 LITTLE BLUFF PL
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City | VANCLEAVE
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State | MS
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Zip | 39565-7170
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Country | US
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Telephone | 228-623-0512
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Fax |
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Provider Business Mailing Address
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Address Line | 13017 LITTLE BLUFF PL
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City | VANCLEAVE
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State | MS
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Zip | 39565-7170
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER/OWNER
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Name | DR. COLETHA DESHAY COLLEY
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Credential | LCSW
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Telephone | 228-623-0512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | NULL
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