Individual
CHARLES COLCLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
25 E 183RD ST, BRONX, NY 10453-1242
(718) 483-1270
(718) 228-7471
Mailing address
85 W BURNSIDE AVE, BRONX, NY 10453-4015
(718) 483-1270
(718) 228-7471
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
078542
NY
Other
Enumeration date
05/22/2007
Last updated
03/30/2012
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