Healthcare Provider Details

I. General information

NPI: 1669673182
Provider Name (Legal Business Name): HEATHER DIGIOVANNI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 LONGWOOD RD
MIDDLE ISLAND NY
11953-2045
US

IV. Provider business mailing address

197 HALF HOLLOW RD
DIX HILLS NY
11746-5861
US

V. Phone/Fax

Practice location:
  • Phone: 631-884-3000
  • Fax:
Mailing address:
  • Phone: 631-370-1820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: