Jessica Kate Colangelo, MSW, LICSW

Individual provider Active NPI Clinical Social Worker · Bolton, MA

NPI 1124284005 · NPPES record last updated Mar 21, 2024

Key facts

NPI
1124284005
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
116645 (MA)
Practice address
141 Green Rd
Bolton, MA 01740-1045
Phone
(978) 758-1806
NPI assigned
Jul 31, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
116645MAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 116645 MA Yes

Addresses

Primary practice location

141 Green Rd
Bolton, MA 01740-1045

Mailing address

141 Green Rd
Bolton, MA 01740-1045
Phone (978) 758-1806

Other providers in Bolton, MA

All providers in Bolton, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.