Provider Demographics
NPI:1720822091
Name:PESCI, COLLEEN FRANCES (LCMHC-A)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:FRANCES
Last Name:PESCI
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 IREDELL ST APT 5
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3561
Mailing Address - Country:US
Mailing Address - Phone:262-501-0337
Mailing Address - Fax:
Practice Address - Street 1:615 DOUGLAS ST STE 500
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6616
Practice Address - Country:US
Practice Address - Phone:855-875-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20130101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health