| Doctor Name: | MRS. JESSICA KATE COLANGELO |
| NPI Number: | 1124284005 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LICSW |
| License Number: | |
| Business Practice Address: | 20 Kinmonth Rd Waban Health & Rehabilitation Waban, MA - 024681503 |
| Business Phone Number: | 6173328481 |
| Business Fax Number: | 6173328959 |
| Mailing Address: | 23 Concord Greene, Unit 4 CONCORD |
| State: | MA |
| Postal Code: | 017423105 |
| Phone Number: | 9787581806 |
| Fax Number: | |
| NPI Enumeration Date: | 07/31/2008 |
| NPI Last Update Date: | 02/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |