Provider Demographics
NPI:1316148521
Name:COLESANTI, BRANDI SUE (MA LMHC)
Entity type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:SUE
Last Name:COLESANTI
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:MS
Other - First Name:BRANDI
Other - Middle Name:SUE
Other - Last Name:GIFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:210 B CLOCK TOWER SQUARE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871
Mailing Address - Country:US
Mailing Address - Phone:401-808-9388
Mailing Address - Fax:
Practice Address - Street 1:210 B CLOCK TOWER SQUARE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871
Practice Address - Country:US
Practice Address - Phone:401-808-9388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00456101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIBG78940Medicaid