| Michelle M. Colarusso, Lcsw | |
|
1582 W San Marcos Blvd Ste 105 San Marcos CA 92078-4081 | |
| (760) 522-7158 | |
| (760) 539-7357 |
| Full Name | Michelle M. Colarusso, Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 1582 W San Marcos Blvd Ste 105, San Marcos, California |
| Authorized Official Name and Position | Carolyn Bowe-mcleod (BILLING MANAGER) |
| Authorized Official Contact | 7604337944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle M. Colarusso, Lcsw 1582 W San Marcos Blvd Ste 105 San Marcos CA 92078-4081 Ph: (760) 522-7158 | Michelle M. Colarusso, Lcsw 1582 W San Marcos Blvd Ste 105 San Marcos CA 92078-4081 Ph: (760) 522-7158 |
| NPI Number | 1740779164 |
|---|---|
| Provider Enumeration Date | 05/02/2018 |
| Last Update Date | 02/17/2023 |
| Certification Date | 06/16/2022 |
| Medicare PECOS PAC ID | 2062769896 |
|---|---|
| Medicare Enrollment ID | O20180724003597 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740779164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 27130 (California) | Primary |
| Provider Name | Michelle M Colarusso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568704807 PECOS PAC ID: 4385929322 Enrollment ID: I20170314001170 |
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