Provider Demographics
NPI:1851803274
Name:COLECCHI, VINCENT W (LISW)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:W
Last Name:COLECCHI
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3469 STEINER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-7365
Mailing Address - Country:US
Mailing Address - Phone:614-558-3397
Mailing Address - Fax:
Practice Address - Street 1:484 COUNTY LINE RD W STE 130
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7246
Practice Address - Country:US
Practice Address - Phone:614-560-1155
Practice Address - Fax:614-423-2959
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2405937104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker