Healthcare Provider Details

I. General information

NPI: 1588840037
Provider Name (Legal Business Name): CATHERINE BECALLO SMITH LCSWR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE BECALLO LCSW

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 7TH NORTH ST STE 100&200
LIVERPOOL NY
13088-6558
US

IV. Provider business mailing address

890 7TH NORTH ST STE 100&200
LIVERPOOL NY
13088-6558
US

V. Phone/Fax

Practice location:
  • Phone: 315-422-0300
  • Fax: 315-452-2455
Mailing address:
  • Phone: 315-422-0300
  • Fax: 315-452-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number074576
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number079157
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: