Healthcare Provider Details

I. General information

NPI: 1568542157
Provider Name (Legal Business Name): MICHELE CLAIRE ALBANO LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELE CLAIRE COLE

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 05/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WALT WHITMAN RD STE LL1
MELVILLE NY
11747-2215
US

IV. Provider business mailing address

16 WHITING RD
EAST QUOGUE NY
11942-4904
US

V. Phone/Fax

Practice location:
  • Phone: 516-698-5511
  • Fax: 516-418-5377
Mailing address:
  • Phone: 631-848-4088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072172-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: