Colby C Agostinelli, LMFT, CST

Individual provider Active NPI Marriage & Family Therapist · Philadelphia, PA

NPI 1891385597 · NPPES record last updated Mar 2, 2023

Key facts

NPI
1891385597
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MF001204 (PA)
Practice address
100 S Broad St Ste 834
Philadelphia, PA 19110-1018
Phone
(267) 603-3758
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MF001204PAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colby Agostinelli, LLC Marriage & Family Therapist Current
since Mar 5, 2023
Accepting new patients

Locations

255 S 17th St
Ste 2100
Philadelphia, PA 19103
Phone (215) 514-6954

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X MF001204 PA Yes

Addresses

Primary practice location

100 S Broad St Ste 834
Philadelphia, PA 19110-1018

Mailing address

255 S 17TH St Ste 2100
Philadelphia, PA 19103-6211

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Marriage & Family Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.