Healthcare Provider Details

I. General information

NPI: 1093644320
Provider Name (Legal Business Name): GIAVONNA ROSEMARY LOBELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 20TH ST
BROOKLYN NY
11232-1253
US

IV. Provider business mailing address

40 MARCY AVE
BROOKLYN NY
11211-4403
US

V. Phone/Fax

Practice location:
  • Phone: 646-685-4422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: