Healthcare Provider Details

I. General information

NPI: 1891343356
Provider Name (Legal Business Name): JEANNINE M CILIOTTA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JEANNINE M M TOMASELLI LMSW

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BROOKLYN COUNSELING SERVICES 7316 13TH AVE 3RD FLOOR
BROOKLYN NY
11228
US

IV. Provider business mailing address

6516 MORGAN HILL TRL APT 1811
WEST PALM BEACH FL
33411-4813
US

V. Phone/Fax

Practice location:
  • Phone: 718-232-8600
  • Fax:
Mailing address:
  • Phone: 718-757-7602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10696301
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number21956
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: