Provider Demographics
NPI:1306005822
Name:SADY-YESHO, COLEEN R (LSW)
Entity type:Individual
Prefix:
First Name:COLEEN
Middle Name:R
Last Name:SADY-YESHO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SCIANDRO DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4559
Mailing Address - Country:US
Mailing Address - Phone:724-850-9353
Mailing Address - Fax:
Practice Address - Street 1:510 SCIANDRO DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4559
Practice Address - Country:US
Practice Address - Phone:724-850-9353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW125658104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker