Provider Demographics
NPI:1962385567
Name:CUSHING, COLLEEN SHELLY (LMHC-D)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:SHELLY
Last Name:CUSHING
Suffix:
Gender:F
Credentials:LMHC-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26F CONGRESS ST # 131
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-4168
Mailing Address - Country:US
Mailing Address - Phone:518-212-7163
Mailing Address - Fax:
Practice Address - Street 1:26F CONGRESS ST # 131
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-4168
Practice Address - Country:US
Practice Address - Phone:518-212-7163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health