Individual
COLBY C AGOSTINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, CST
Contact information
Practice address
100 S BROAD ST STE 834, PHILADELPHIA, PA 19110-1018
(267) 603-3758
Mailing address
255 S 17TH ST STE 2100, PHILADELPHIA, PA 19103-6211
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
MF001204
PA
Other
Enumeration date
01/26/2021
Last updated
03/02/2023
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