Provider Demographics
NPI:1053759480
Name:SYLVESTER, COLLEEN M (LICSW)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:M
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:M
Other - Last Name:SYLVESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:500 UNICORN PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:781-994-7656
Mailing Address - Fax:781-994-7642
Practice Address - Street 1:500 UNICORN PARK DRIVE
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-994-7656
Practice Address - Fax:781-994-7642
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0879301041C0700X
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical