Provider Demographics
NPI:1902557002
Name:KLOSINSKI, COLTON JAMES
Entity type:Individual
Prefix:
First Name:COLTON
Middle Name:JAMES
Last Name:KLOSINSKI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:COLTON
Other - Middle Name:
Other - Last Name:HAGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 S ALLEN ST STE 117
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4848
Mailing Address - Country:US
Mailing Address - Phone:814-308-0704
Mailing Address - Fax:
Practice Address - Street 1:225 HIGH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1336
Practice Address - Country:US
Practice Address - Phone:814-308-0704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional