Provider Demographics
NPI:1134387517
Name:STREIB, COLLEEN ANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:ANNE
Last Name:STREIB
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 HIGH ST # 7
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3808
Mailing Address - Country:US
Mailing Address - Phone:800-234-4400
Mailing Address - Fax:772-251-0822
Practice Address - Street 1:360 NW 27TH ST # 8-109
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-4158
Practice Address - Country:US
Practice Address - Phone:800-423-4400
Practice Address - Fax:772-251-0822
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 135631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004068284Medicaid